Effect of age at onset on the course of major depressive disorder

Sidney Zisook, Ira Lesser, Jonathan W. Stewart, Stephen R. Wisniewski, G. K. Balasubramani, Maurizio Fava, William S. Gilmer, Timothy R. Dresselhaus, Michael E. Thase, Andrew A. Nierenberg, Madhukar H. Trivedi, A. John Rush

Research output: Contribution to journalArticle

217 Citations (Scopus)

Abstract

Objective: This report assesses whether age at onset defines a specific subgroup of major depressive disorder in 4,041 participants who entered the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Method: The study enrolled outpatients 18-75 years of age with nonpsychotic major depressive disorder from both primary care and psychiatric care practices. At study entry, participants estimated the age at which they experienced the onset of their first major depressive episode. This report divides the population into five age-at-onset groups: childhood onset (ages <12), adolescent onset (ages 12-17), early adult onset (ages 18-44), middle adult onset (ages 45-59), and late adult onset (ages ≥60). Results: No group clearly stood out as distinct from the others. Rather, the authors observed an apparent gradient, with earlier ages at onset associated with never being married, more impaired social and occupational function, poorer quality of life, greater medical and psychiatric comorbidity, a more negative view of life and the self, more lifetime depressive episodes and suicide attempts, and greater symptom seventy and suicidal ideation in the index episode compared to those with later ages at onset of major depressive disorder. Conclusions: Although age at onset does not define distinct depressive subgroups, earlier onset is associated with multiple indicators of greater illness burden across a wide range of indicators. Age of onset was not associated with a difference in treatment response to the initial trial of citalopram.

Original languageEnglish (US)
Pages (from-to)1539-1546
Number of pages8
JournalAmerican Journal of Psychiatry
Volume164
Issue number10
DOIs
StatePublished - Oct 2007

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Major Depressive Disorder
Age of Onset
Psychiatry
Suicidal Ideation
Citalopram
Cost of Illness
Suicide
Comorbidity
Primary Health Care
Outpatients
Quality of Life
Depression

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Zisook, S., Lesser, I., Stewart, J. W., Wisniewski, S. R., Balasubramani, G. K., Fava, M., ... Rush, A. J. (2007). Effect of age at onset on the course of major depressive disorder. American Journal of Psychiatry, 164(10), 1539-1546. https://doi.org/10.1176/appi.ajp.2007.06101757

Effect of age at onset on the course of major depressive disorder. / Zisook, Sidney; Lesser, Ira; Stewart, Jonathan W.; Wisniewski, Stephen R.; Balasubramani, G. K.; Fava, Maurizio; Gilmer, William S.; Dresselhaus, Timothy R.; Thase, Michael E.; Nierenberg, Andrew A.; Trivedi, Madhukar H.; Rush, A. John.

In: American Journal of Psychiatry, Vol. 164, No. 10, 10.2007, p. 1539-1546.

Research output: Contribution to journalArticle

Zisook, S, Lesser, I, Stewart, JW, Wisniewski, SR, Balasubramani, GK, Fava, M, Gilmer, WS, Dresselhaus, TR, Thase, ME, Nierenberg, AA, Trivedi, MH & Rush, AJ 2007, 'Effect of age at onset on the course of major depressive disorder', American Journal of Psychiatry, vol. 164, no. 10, pp. 1539-1546. https://doi.org/10.1176/appi.ajp.2007.06101757
Zisook S, Lesser I, Stewart JW, Wisniewski SR, Balasubramani GK, Fava M et al. Effect of age at onset on the course of major depressive disorder. American Journal of Psychiatry. 2007 Oct;164(10):1539-1546. https://doi.org/10.1176/appi.ajp.2007.06101757
Zisook, Sidney ; Lesser, Ira ; Stewart, Jonathan W. ; Wisniewski, Stephen R. ; Balasubramani, G. K. ; Fava, Maurizio ; Gilmer, William S. ; Dresselhaus, Timothy R. ; Thase, Michael E. ; Nierenberg, Andrew A. ; Trivedi, Madhukar H. ; Rush, A. John. / Effect of age at onset on the course of major depressive disorder. In: American Journal of Psychiatry. 2007 ; Vol. 164, No. 10. pp. 1539-1546.
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