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Cited by 542Mental Health Treatment and AccessAging, Health, and DisabilityTreatment of Major Depression

Age differences in major depression: Results from the national comorbidity survey replication (NCS-R)

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Kessler, R. C., Birnbaum, H., Bromet, E., Hwang, I., Sampson, N., Shahly, V.·2010·Psychological Medicine
DOI 10.1017/s0033291709990213PMC PMC2813515
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Abstract

BACKGROUND: Although depression appears to decrease in late life, this could be due to misattribution of depressive symptom to physical disorders that increase in late life. METHOD: We studied age differences in major depressive episodes (MDE) in the National Comorbidity Survey Replication, a national survey of the US household population. DSM-IV MDE was defined without organic exclusions or diagnostic hierarchy rules to facilitate analysis of co-morbidity. Physical disorders were assessed with a standard chronic conditions checklist and mental disorders with the WHO Composite International Diagnostic Interview (CIDI) version 3.0. RESULTS: Lifetime and recent DSM-IV/CIDI MDE were significantly less prevalent among respondents aged 65 years than among younger adults. Recent episode severity, but not duration, was also lower among the elderly. Despite prevalence of mental disorders decreasing with age, co-morbidity of hierarchy-free MDE with these disorders was either highest among the elderly or unrelated to age. Co-morbidity of MDE with physical disorders, in comparison, generally decreased with age despite prevalence of co-morbid physical disorders usually increasing. Somewhat more than half of respondents with 12-month MDE received past-year treatment, but the percentage in treatment was lowest and most concentrated in the general medical sector among the elderly. CONCLUSIONS: Given that physical disorders increase with age independent of depression, their lower associations with MDE in old age argue that causal effects of physical disorders on MDE weaken in old age. This result argues against the suggestion that the low estimated prevalence of MDE among the elderly is due to increased confounding with physical disorders.

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  • Previous studies have consistently demonstrated higher rates of depressive symptoms and suicidal ideation among young adults.

    “previous studies have consistently demonstrated higher rates of depressive symptoms (Kessler et al., 2010) and suicidal ideation (Crosby et al., 1999) among young adults.”

    From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Kessler et al., 2010

    The Results (Prevalence estimates; page not supplied) report that major depressive episodes were less prevalent among adults aged 65+ than among younger groups, including ages 18–34. This supports an age difference in depression, but the paper measures major depressive episodes rather than rates of depressive symptoms generally, and its finding is driven largely by the lower rate in the oldest group. Suicidal ideation is attributed to a different citation and is not assessed here. (LLM, conf=0.84)

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  • A higher prevalence of depressive symptoms has consistently been found in women compared to men.

    “While a higher prevalence of depressive symptoms has consistently been found in women compared to men, the relationship of the prevalence with age is less clear.”

    From Prevalence and age patterns of depression in the United Kingdom. A population-based study (2021) · cites this paper as Kessler et al., 2010

  • Both sex and age have been systematically related to the prevalence of depression.

    “Both sex and age have been systematically related to the prevalence of depression (Arias-de la Torre et al., 2018;Kessler et al., 2010;Patel et al., 2018a).”

    From Prevalence and age patterns of depression in the United Kingdom. A population-based study (2021) · cites this paper as Kessler et al., 2010

  • Impairments at young ages of adulthood are more strongly associated with major depressive disorder than those occurring at advanced ages.

    “Furthermore, although epidemiological data consistently link MDD and physical illness, the strength of this association diminishes with age; impairments at young ages of adulthood are more strongly associated with MDD than those occurring at advanced ages, when some loss in functioning is normative and expected (16).”

    From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [16]

  • Epidemiological data consistently link major depressive disorder and physical illness.

    “Furthermore, although epidemiological data consistently link MDD and physical illness, the strength of this association diminishes with age; impairments at young ages of adulthood are more strongly associated with MDD than those occurring at advanced ages, when some loss in functioning is normative and expected (16).”

    From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [16]

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Authors
Kessler, R. C., Birnbaum, H., Bromet, E., Hwang, I., Sampson, N., & Shahly, V.
Affiliations
  • Harvard University (US)
  • Analysis Group (United States) (US)
  • State University of New York (US)
  • Boston Psychoanalytic Society and Institute (US)
Corresponding author
Kessler, R. C.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2009-06-17
Volume
40
Issue
2
Pages
225-237
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291709990213
PMC
PMC2813515
OpenAlex
W2152919321
Cited by
542
References
43
Citations by year
2026: 19 · 2025: 33 · 2024: 26 · 2023: 34 · 2022: 34 · 2021: 50 · 2020: 41 · 2019: 37 · 2018: 28 · 2017: 33 · 2016: 39 · 2015: 27 · 2014: 45 · 2013: 28 · 2012: 33
FWCI
28.79
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U13MH066849, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (K05DA015799, R01DA016558)
  • Fogarty International Center (R03TW006481)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
major depressive episode, age differences, geriatric depression, comorbidities, physical disorders, depression prevalence, depression severity, treatment utilization, older adults
MeSH terms
Adolescent, Adult, Age Factors, Aged, Mental Disorders, Major Depressive Disorder, Female, Humans, Interpersonal Relations, Male, Middle Aged, Population Surveillance, Surveys and Questionnaires, Severity of Illness Index, United States, Reproducibility of Results, Comorbidity, Prevalence, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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