title: Younger onset of depression is associated with greater suicidal intent.
abstract: BACKGROUND
  Age of onset of major depression seems to be dropping in Western nations. Early onset usually predicts a more serious illness with a relatively poor prognosis. Since depression is associated with suicide, this begs the question of whether early onset of depression is associated with the degree of intent of suicidal behaviour, and whether this relationship differs according to gender.
  
  
  METHODS
  Relevant responses from 9,282 residents of the United States were drawn from a nationally representative community survey conducted in 2001 through 2003 using the W.H.O. version of the Composite International Diagnostic Interview. The primary outcome measure was the retrospectively determined age of first major depressive episode.
  
  
  RESULTS
  Younger age of onset for depression was associated with higher levels of suicidal intent, irrespective of age at the time of interview. A significant interaction between level of intent and age at interview appeared to be accounted for by the later onset among those in the eldest cohort who reported an absence of suicidal behaviour. The influence of suicidal intent on onset of depression was greater for women than for men.
  
  
  CONCLUSIONS
  The earlier the age of first symptoms of major depressive episode, the higher the degree of suicidal intent, irrespective of age at interview and gender, although the more pronounced trend for women suggests a greater sensitivity to underlying factors that may involve depression and lead to suicide risk.
authors.affiliation: Department of Public Health, Flinders University, G3-FMC Flats, Bedford Park, SA 5042, Australia. angus.thompson@flinders.edu.au
authors.forename: Angus H
authors.initials: AH
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D015331:Cohort Studies; D003625:Data Collection / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology