Cited by 212Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

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Age of onset in chronic major depression: relation to demographic and clinical variables, family history, and treatment response

Klein, Daniel N, Schatzberg, Alan F, McCullough, James P, Dowling, Frank, Goodman, Daniel, Howland, Robert H, Markowitz, John C, Smith, Christine, Thase, Michael E, Rush, A.John, LaVange, Lisa, Harrison, Wilma M, Keller, Martin B·1999·Journal of Affective Disorders

DOI 10.1016/s0165-0327(99)00020-8

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Abstract

Background The clinical and etiological significance of the early-late onset distinction in chronic major depressive disorder was explored.Method Subjects were 289 outpatients with DSM-III-R chronic major depression drawn from a multi-site study comparing the efficacy of sertraline and imipramine in the acute and long-term treatment of chronic depression. Patients received comprehensive evaluations using semi-structured interviews and rating scales.Results Early-onset chronic major depression was associated with a longer index major depressive episode and higher rates of recurrent major depressive episodes, comorbid personality disorders, lifetime substance use disorders, depressive personality traits, and a history of psychiatric hospitalization. In addition, more early-onset patients tended to have a family history of mood disorders. The early-late onset distinction was not associated with differences in symptom severity, functional impairment, or treatment response.Limitations Family members were not interviewed directly; there were a large number of statistical comparisons; and interrater reliability of the assessments was not evaluated.Conclusions Early-onset chronic major depression has a more malignant course and is associated with greater comorbidity than late-onset chronic major depression.

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Authors: Klein, D. N., Schatzberg, A. F., McCullough, J. P., Dowling, F., Goodman, D., Howland, R. H., Markowitz, J. C., Smith, C., Thase, M. E., Rush, A. J., LaVange, L., Harrison, W. M., & Keller, M. B.
Affiliations: State University of New York (US)
Stanford Medicine (US)
Virginia Commonwealth University (US)
Cornell University (US)
University of Pittsburgh (US)
The University of Texas Southwestern Medical Center (US)
IQVIA (United States) (US)
Pfizer (United States) (US)
Brown University (US)
Corresponding author: Klein, Daniel N
ORCID: Klein, Daniel N
Schatzberg, Alan F
McCullough, James P
Howland, Robert H
Markowitz, John C
Rush, A.John
LaVange, Lisa
Keller, Martin B
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 1999-10
Volume: 55
Issue: 2-3
Pages: 149-157
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/s0165-0327(99)00020-8
OpenAlex: W2003250894
Cited by: 212
References: 32
Citations by year: 2026: 2 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 7 · 2021: 6 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 10 · 2016: 11 · 2015: 12 · 2014: 9 · 2013: 10 · 2012: 15
FWCI: 2.61
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (U01MH061590)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: age of onset, early-onset depression, late-onset depression, family history of mood disorders, depressive episode duration, recurrence, personality disorders, substance use disorders, psychiatric hospitalization, treatment response, sertraline, imipramine, comorbidities
MeSH terms: Adult, Aged, Antidepressive Agents, Tricyclic, Demography, Depressive Disorder, Family Health, Female, Humans, Imipramine, Male, Middle Aged, Prognosis, Comorbidity, Treatment Outcome, Age of Onset

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Age of onset in chronic major depression: relation to demographic and clinical variables, family history, and treatment response

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