Does Age at Onset of First Major Depressive Episode Indicate the Subtype of Major Depressive Disorder?: The Clinical Research Center for Depression Study
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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 majordepressive 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-reportedby 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 analysisof covariance (ANCOVA) and ordinal logistic regression analysis with adjustingthe effect of age, the relationships between clinical features and age at onset of MDD were evaluated. Results: There was an apparent, but inconsistent correlationbetween clinical features and age at onset. Earlier onset MDD was significantlyassociated 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 symptomsubscale (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.
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 majordepressive 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-reportedby 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 analysisof covariance (ANCOVA) and ordinal logistic regression analysis with adjustingthe effect of age, the relationships between clinical features and age at onset of MDD were evaluated. Results: There was an apparent, but inconsistent correlationbetween clinical features and age at onset. Earlier onset MDD was significantlyassociated 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 symptomsubscale (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.
참고문헌 (38)
- 석정호, "Impact of Early-Life Stress and Resilience on Patients with Major Depressive Disorder", Yonsei Medical Journal, 53(6), pp.1093~1098 (2012), 연세대학교의과대학[DOI]
- Kendler KS, "Stressful life events, genetic liability, and onset of an episode of major depression in women", Am J Psychiatry, 152, pp.833~842 (1995)
- Paykel ES, "Classification of depressed patients: a cluster analysis derived grouping", Br J Psychiatry, 118, pp.275~288 (1971)
- Lichtenberg P, "Subtyping major depressive disorder", Psychother Psychosom, 79, pp.131~135 (2010)
- Zhu T, "Admixture analysis of age at onset in major depressive disorder", Gen Hosp Psychiatry, 34, pp.686~691 (2012)
- Jaffee SR, "Differences in early childhood risk factors for juvenile-onset and adult-onset depression", Arch Gen Psychiatry, 59, pp.215~222 (2002)
- Zisook S, "Factors that differentiate early vs. later onset of major depression disorder", Psychiatry Res, 129, pp.127~140 (2004)
- Zisook S, "Preadult onset vs. adult onset of major depressive disorder:a replication study", Acta Psychiatr Scand, 115, pp.196~205 (2007)
- Yang F, "Age at onset of major depressive disorder in Han Chinese women: relationship with clinical features and family history", J Affect Disord, 135, pp.89~94 (2011)
- Muhonen LH, "Age at onset of first depressive episode as a predictor for escitalopram treatment of major depression comorbid with alcohol dependence", Psychiatry Res, 167, pp.115~122 (2009)
- Frank MG, "Age at onset of major depressive disorder predicts reductions in NK cell number and activity", J Affect Disord, 71, pp.159~167 (2002)
- Benazzi F, "Classifying mood disorders by age-at-onset instead of polarity", Prog Neuropsychopharmacol Biol Psychiatry, 33, pp.86~93 (2009)
- 박선철, "Prevalence and Clinical Correlates of Insomnia in Depressive Disorders: The CRESCEND Study", PSYCHIATRY INVESTIGATION, 10(4), pp.373~381 (2013), 대한신경정신의학회
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders. 4th ed" (1994), American Psychiatric Press
- P, Version 2.0), "Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I", pp.1995, First MB
- Farrer LA, "Reliability of self-reported age at onset of major depression", J Psychiatr Res, 23, pp.35~47 (1989)
- Prusoff BA, "Lifetime prevalence and age of onset of psychiatric disorders: recall 4 years later", J Psychiatr Res, 22, pp.107~117 (1988)
- Zisook S, "Effect of age at onset on the course of major depressive disorder", Am J Psychiatry, 164, pp.1539~1546 (2007)
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Hamilton M, "The assessment of anxiety states by rating", Br J Med Psychol, 32, pp.50~55 (1959)
- Overall JE, "The brief psychiatric rating scale", Psychol Rep, 10, pp.779~812 (1962)
- Guy W, "ECDEU Assessment Manual for Psychopharmacology" (1976), U.S. Department of Health, Education, and Welfare Publication, National Institute of Mental Health
- Goldman HH, "Revising axis V for DSMIV:a review of measures of social functioning", Am J Psychiatry, 149, pp.1148~1156 (1992)
- Beck AT, "Assessment of suicidal intention:the Scale for Suicide Ideation", J Consult Clin Psychol, 47, pp.343~352 (1979)
- "Development of the World Health Organization WHOQOLBREF quality of life assessment. The WHOQOL Group", Psychol Med, 28, pp.551~558 (1998)
- Saunders JB, "Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II", Addiction, 88, pp.791~804 (1993)
- 이중서, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구", 신경정신의학, 44(4), pp.456~465 (2005), 대한신경정신의학회
- 이준영, "총괄기능평가척도(Global Assessment of Functioning Scale)와 사회적, 직업적 기능평가척도(Social and Occupational Functioning Scale)", 대한정신약물학회지, 17(2), pp.122~127 (2006), 대한정신약물학회
- Joe KH, "Optimum cut-off score for screening of hazardous drinking using the Korean version of Alcohol Use Disorder Identification Test (AUDIT-K)", J Korean Academy of Addiction Psychiatry, 13, pp.34~40 (2009)
- Wilkowska-Chmielewska J, "Age-dependent symptomatology of depression in hospitalized patients and its implications for DSM-5", J Affect Disord, 150, pp.142~145 (2013)
- Galynker II, "Hypofrontality and negative symptoms in major depressive disorder", J Nucl Med, 39, pp.608~612 (1998)
- Galynker II, "Negative symptoms in patients with major depressive disorder: a preliminary report", Neuropsychiatry Neuropsychol Behav Neurol, 13, pp.171~176 (2000)
- Nurnberger JI Jr, "Evidence for a locus on chromosome 1 that influences vulnerability to alcoholism and affective disorder", Am J Psychiatry, 158, pp.718~724 (2001)
- Lyons MJ, "Specificity of familial vulnerability for alcoholism versus major depression in men", J Nerv Ment Dis, 194, pp.809~817 (2006)
- Gokturk C, "Serotonin transporter (5-HTTLPR) and monoamine oxidase (MAOA) promoter polymorphisms in women with severe alcoholism", Arch Womens Ment Health, 11, pp.347~355 (2008)
- Alpert JE, "Patterns of axis I comorbidity in earlyonset versus late-onset major depressive disorder", Biol Psychiatry, 46, pp.202~211 (1999)
- Klein DN, "Age of onset in chronic major depression:relation to demographic and clinical variables, family history, and treatment response", J Affect Disord, 55, pp.149~157 (1999)
- Korten NC, "Early and late onset depression in young and middle aged adults: differential symptomatology, characteristics and risk factors?", J Affect Disord, 138, pp.259~267 (2012)