Treatment outcomes for older depressed patients with earlier versus late onset of first depressive episode: a Sequenced Treatment Alternatives to Relieve Depression (STAR*D) report.
OBJECTIVE
Controversy exists whether age at onset of the first depressive episode predicts chance of response and remission or the timing of such outcome. In this study of older depressed outpatients, the authors evaluated whether the age at onset of the first major depressive episode (MDE) was related to clinical outcomes.


METHODS
Post-hoc dataset analysis for older participants treated with citalopram in the Sequenced Treatment Alternatives to Relieve Depression trial was performed. Side effects, remission rates, and baseline characteristics were compared for participants whose first MDE began at or before age 55 (earlier onset) versus those with their first MDE after age 55 (late onset).


METHODS
Participants were enrolled from 23 psychiatric and 18 primary care settings.


METHODS
There were 574 treatment-seeking outpatients (age range: 55-75 years) with nonpsychotic major depressive disorder who had a baseline 17-item Hamilton Rating Scale for Depression score of > or =14.


METHODS
Participants received citalopram treatment for up to 14 weeks.


METHODS
Remission was defined by a 16-item Quick Inventory of Depressive Symptomatology-Self-Rated score of < or =5 at study exit. Side effects were measured by the Frequency, Intensity, and Burden of Side Effects Rating.


RESULTS
Of 574 participants, 72.1% had earlier-onset depression and 27.9% had late-onset depression. Remission rates were not statistically different between earlier-onset (30.8%) and late-onset (31.9%) participants. Time to remission did not differ as well.


CONCLUSIONS
The self-reported age at onset of the first MDE being after age 55 was not related to clinical outcomes for participants 55 to 75 years of age.
Kozel
F Andrew
FA
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. Andrew.Kozel@utsouthwestern.edu
Trivedi
Madhukar H
MH
Wisniewski
Stephen R
SR
Miyahara
Sachiko
S
Husain
Mustafa M
MM
Fava
Maurizio
M
Lebowitz
Barry
B
Zisook
Sidney
S
Rush
A John
AJ
D017668:Age of Onset; D000368:Aged; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012044:Regression Analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors