Yonsei Med J.  2014 Nov;55(6):1712-1720. 10.3349/ymj.2014.55.6.1712.

Does Age at Onset of First Major Depressive Episode Indicate the Subtype of Major Depressive Disorder?: The Clinical Research Center for Depression Study

• Park SC
• Hahn SW
• Hwang TY
• Kim JM
• Jun TY
• Lee MS
• Kim JB
• Yim HW
• Park YC

• KMID: 2070222
• DOI: http://doi.org/10.3349/ymj.2014.55.6.1712

Abstract

PURPOSE
The purpose of this study was to evaluate the effects of age at onset of the first major depressive episode on the clinical features of individuals with major depressive disorder (MDD) in a large cohort of Korean depressed patients.
MATERIALS AND METHODS
We recruited 419 MDD patients of age over 18 years from the Clinical Research Center for Depression study in South Korea. At the start of the study, the onset age of the first major depressive episode was self-reported by the subjects. The subjects were divided into four age-at-onset subgroups: childhood and adolescent onset (ages <18), early adult onset (ages 18-44), middle adult onset (ages 45-59), and late onset (ages 60+). Using analysis of covariance (ANCOVA) and ordinal logistic regression analysis with adjusting the effect of age, the relationships between clinical features and age at onset of MDD were evaluated.
RESULTS
There was an apparent, but inconsistent correlation between clinical features and age at onset. Earlier onset MDD was significantly associated with higher proportion of female gender [adjusted odds ratio (AOR)=0.570, p=0.022], more previous suicide attempts (AOR=0.635, p=0.038), greater number of previous depressive episodes (F=3.475, p=0.016) and higher scores on the brief psychiatric rating scale (F=3.254, p=0.022), its negative symptom subscale (F=6.082, p<0.0001), and the alcohol use disorder identification test (F=7.061, p<0.0001).
CONCLUSION
Early age at onset may increase the likelihood of distinguishable MDD subtype, and age at onset of the first major depressive episode is a promising clinical indicator for the clinical presentation, course, and outcome of MDD.

Keyword

Major depressive disorder; age at onset; clinical indicator; subtype

MeSH Terms

Adolescent
Adult
Age Distribution
Age of Onset
Aged
Depression/epidemiology
Depressive Disorder, Major/*classification/*diagnosis/psychology
Female
Humans
Life Change Events
Male
Middle Aged
Odds Ratio
Psychiatric Status Rating Scales
Regression Analysis
Republic of Korea
Suicide, Attempted/psychology
Young Adult

Figure

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  Fig. 1 Process and criteria for selecting subjects. SCID, Structured Clinical Interview for DSM-IV.

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  Fig. 2 Distribution of ages at onset of the first major depressive episode (n=419).

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  Fig. 3 Subgroups in terms of age at onset of the first major depressive episode.

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