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Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R)
Open accessAbstract
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 (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
Experimental — accuracy not yet measuredIn the citing paper
“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
In the citing paper
“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
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Metadata
- 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.
- 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
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Pharmacology (medical) › 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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