title: Is early-onset in major depression a predictor of specific clinical features with more impaired social function?
abstract: BACKGROUND
  Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features, accompanying impaired social function, protracted recovery time, and frequent recurrence. This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia.
  
  
  METHODS
  In total, 547 out-patients aged 18-65 years who were from 13 study sites in five Asian countries were included. These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition criteria. Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS). Quality of life was assessed by a 36-item Short-form Health Survey (SF-36). Analyses were performed using a continuous or dichotomous (cut-off: 30 years) age-of-onset indicator.
  
  
  RESULTS
  Early-onset MDD (EOD, <30 years) was associated with longer illness (P = 0.003), unmarried status (P < 0.001), higher neuroticism (P ≤ 0.002) based on the SCL-90-R, and more limited social function and mental health (P = 0.006, P = 0.007) based on the SF-36 and SDS. The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages. Special clinical features and more impaired social function and quality of life were associated with EOD, as in western studies.
  
  
  CONCLUSIONS
  EOD often follows higher levels of neuroticism. Age of onset of MDD may be a predictor of clinical features and impaired social function, allowing earlier diagnosis and treatment.
authors.forename: Yan-Hong
authors.initials: YH
authors.lastname: Liu
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.forename: Yun-Ai
authors.initials: YA
authors.lastname: Su
authors.forename: Yi-Ru
authors.initials: YR
authors.lastname: Fang
authors.forename: Manit
authors.initials: M
authors.lastname: Srisurapanont
authors.forename: Jin Pyo
authors.initials: JP
authors.lastname: Hong
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hatim
authors.forename: Hong Choon
authors.initials: HC
authors.lastname: Chua
authors.forename: Dianne
authors.initials: D
authors.lastname: Bautista
authors.affiliation: Key Laboratory of Mental Health, Ministry of Mental Health and Peking University Institute of Mental Health, Beijing 100191, China.
authors.forename: Tian-Mei
authors.initials: TM
authors.lastname: Si
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000075384:Neuroticism; D011788:Quality of Life; D055815:Young Adult