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Age of onset in chronic major depression: relation to demographic and clinical variables, family history, and treatment response
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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“On the other hand, the decreased functional connectomes in areas of the DMN and LIM are considered to be related to anhedonia [62-68]”
From Mapping neurophysiological subtypes of major depressive disorder using normative models of the functional connectome (2023) · cites this paper as [66]
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Metadata
- 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
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1999-10
- Volume
- 55
- Issue
- 2-3
- Pages
- 149-157
- ISSN
- 0165-0327 (ISSN-L)
- 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
- 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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