Course profiles of early- and adult-onset depression.
BACKGROUND
The age of onset of major depression may produce divergent profiles of recovery after treatment.


METHODS
Symptom level and course trajectories of with early- and adult-onset of major depression were followed prospectively over 2 years in 62 adult outpatients who recovered from DSM-III-R unipolar major depression after cognitive behavior therapy. We compared individuals with depression onset before age 20 (n = 31) with those with onset after age 20 (n = 31), controlling for current age, education, and history of depression, and accounting for their return to mental health treatment. Participants completed psychiatric and psychosocial assessments before and after treatment, and every 6 months for 2 years post-treatment. We analyzed severity and changes of weekly depressive symptoms to construct profiles of recovery for the early- and adult-onset groups.


RESULTS
Our data indicated: (a) on average, the early-onset group experienced consistently more depressive symptoms than the adult-onset group; (b) the pattern of symptoms remained level for both groups during the 2-year follow-up; (c) both groups maintained parallel and stable course profiles over the 2-year follow-up; and, (d) early age of onset was associated with higher rate of depressive relapse.


CONCLUSIONS
Accuracy of the ratings of depressive symptoms may have been limited by the retrospective nature of the psychiatric status ratings.


CONCLUSIONS
Results suggest that among our recovered participants, early age of onset is associated with shorter time to relapse, more residual symptoms over the follow-up, and a stable and linear course of residual symptoms during the 2-year follow-up.
Gollan
Jackie
J
Depression Research Program, Department of Psychiatry, University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637, USA. jgollan@uchicago.edu
Raffety
Brian
B
Gortner
Eric
E
Dobson
Keith
K
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002648:Child; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D016896:Treatment Outcome