title: Age-related variability in the presentation of symptoms of major depressive disorder.
abstract: BACKGROUND
  The heterogeneous aetiology of major depressive disorder (MDD) might affect the presentation of depressive symptoms across the lifespan. We examined to what extent a range of mood, cognitive, and somatic/vegetative depressive symptoms were differentially present depending on patient's age.
  
  
  METHODS
  Data came from 1404 participants with current MDD (aged 18-88 years) from two cohort studies: the Netherlands Study of Depression and Anxiety (NESDA) and the Netherlands Study of Depression in Older Persons (NESDO). Associations between age (per 10 years) and 30 depressive symptoms as well as three symptom clusters (mood, cognitive, somatic/vegetative) were assessed using logistic and linear regression analyses.
  
  
  RESULTS
  Depression severity was found to be stable with increasing age. Nevertheless, 20 (67%) out of 30 symptoms were associated with age. Most clearly, with ageing there was more often early morning awakening [odds ratio (OR) 1.47, 95% confidence interval (CI) 1.36-1.60], reduced interest in sex (OR 1.42, 95% CI 1.31-1.53), and problems sleeping during the night (OR 1.33, 95% CI 1.24-1.43), whereas symptoms most strongly associated with younger age were interpersonal sensitivity (OR 0.72, 95% CI 0.66-0.79), feeling irritable (OR 0.73, 95% CI 0.67-0.79), and sleeping too much (OR 0.75, 95% CI 0.68-0.83). The sum score of somatic/vegetative symptoms was associated with older age (B = 0.23, p < 0.001), whereas the mood and cognitive sum scores were associated with younger age (B = -0.20, p < 0.001; B = -0.04, p = 0.004).
  
  
  CONCLUSIONS
  Depression severity was found to be stable across the lifespan, yet depressive symptoms tend to shift with age from being predominantly mood-related to being more somatic/vegetative. Due to the increasing somatic presentation of depression with age, diagnoses may be missed.
authors: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands.
authors: R
authors: R
authors: Schaakxs
authors: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands.
authors: H C
authors: HC
authors: Comijs
authors: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands.
authors: F
authors: F
authors: Lamers
authors: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands.
authors: A T F
authors: AT
authors: Beekman
authors: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands.
authors: B W J H
authors: BW
authors: Penninx
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000503:physiopathology*; D018450:Disease Progression; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Ageing; depressive symptoms; major depressive disorder