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

Abstract

PurposeThe 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 MethodsWe 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.ResultsThere 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).ConclusionEarly 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.

Gray Matter Volume Abnormalities in Depressive Patients With and Without Anxiety Disorders

“… 51 Besides, a recent study has demonstrated that early age at onset may increase the likelihood of distinguishable MDD subtype, and age at onset of the first episode MDD is a promising clinical indicator for the clinical presentation, course, and outcome of MDD. 52 To better explore the neuroanatomical characteristics of depression and anxiety disorders, it would be useful to recruit drug-naive, first-episode patients of depression and anxiety disorders in the future study. Second, the results of our VBM analyses were inconsistent with many previous studies.…”

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“…similar mean age has been found in multiple studies. [23][24][25] The mean age of onset of illness of depression with suicidal behaviour patients was 32.6±11.90 years, previous studies have found mean age of onset to be around 39±5 years. 26 Depression without suicidal behaviour patients had a mean HAM-D score of 15.28±2.80 equivalent of moderate depression while depression with suicidal behaviour patients had a mean HAM-D score of 20.36±7.04 which corresponds to severe depression as per HAM-D (Table 2).…”