Pre-adult onset and patterns of suicidality in patients with a history of recurrent depression.
BACKGROUND
This report assesses the association between age of onset of major depression and later suicidality in a sample of 276 recurrently depressed patients recruited for the Oxford/Bangor Staying Well after Depression (SWAD) Trial, and interviewed when in remission.


METHODS
The study enrolled adult patients with a history of at least three episodes of non-psychotic major depressive disorder from primary care and psychiatric care practices and through community advertisements. At study entry, all participants estimated the age of their first onset of a major depressive episode and completed both self-report and interview-based assessments of past and current suicidal ideation and behavior. Participants were divided into pre-adult and adult onset groups using a cut-off age of 18.


RESULTS
Forty-eight percent of the sample reported a pre-adult age of onset. Pre-adult age of onset was significantly associated with suicidality, both from self-report and from interviewer assessment even when adjusting for differences in age, gender, employment status, length of the disorder and early adversity.


CONCLUSIONS
Relevant variables were all assessed through retrospective reports.


CONCLUSIONS
Pre-adult age of onset is closely associated with risk for and severity of later suicidality, replicating, in a sample of patients assessed when in remission, findings from studies that assessed patients when currently depressed. The association of pre-adult age of onset with suicidality is not due to differences in sociodemographic variables, length of the disorder and early adversity.
University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK. mark.williams@psych.ox.ac.uk
J Mark G
JM
Williams
Thorsten
T
Barnhofer
Catherine
C
Crane
Danielle S
DS
Duggan
Dhruvi
D
Shah
Kate
K
Brennan
Adele
A
Krusche
Rebecca
R
Crane
Catrin
C
Eames
Mariel
M
Jones
Sholto
S
Radford
Ian T
IT
Russell
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult