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

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Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R)

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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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Research works printed but not linked: 3

  1. Schoenborn, 2003, Summary health statistics for the U.S. population: National Health Interview Survey, 2000, Vital and Health Statistics, 10, 1
  2. 10.3386/w8419 · DOI
  3. 2002, SUDAAN: Professional Software for Survey Data Analysis [computer program]

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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
Published
2009-06-17
Volume
40
Issue
2
Pages
225-237
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
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
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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