Le Xiao1, Jing-Jing Zhou1, Yuan Feng1, Xue-Quan Zhu1, Wen-Yuan Wu2, Yong-Dong Hu3, Ya-Juan Niu4, Jian Hu5, Xue-Yi Wang6, Cheng-Ge Gao7, Ning Zhang8, Yi-Ru Fang9, Tie-Bang Liu10, Fu-Jun Jia11, Lei Feng12, Gang Wang13. 1. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China. 2. Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, China. 3. Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 4. Department of Psychiatry, Beijing HuiLongGuan Hospital, Beijing, China. 5. Department of Psychiatry, the First Affiliated Hospital of Harbin Medical University, Harbin, China. 6. Department of Psychiatry, the First Hospital of Hebei Medical University, Hebei, China. 7. Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China. 8. Department of Psychiatry, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China. 9. Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 10. Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, China. 11. Department of Psychiatry, Guangdong Mental Health Center, Guangdong General Hospital, Guangzhou, China. 12. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China. Electronic address: flxlm@126.com. 13. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China. Electronic address: gangwangdoc@vip.163.com.
Abstract
AIMS & OBJECTIVES: Age differences exist in many aspects in patients with major depressive disorder (MDD). The present study aims to examine the effect of age on treatment outcomes in first-episode MDD. METHODOLOGY: A total of 982 first-episode major depressive patients, who were above 18 years old and admitted in both psychiatric hospitals and units of general hospitals were recruited for the present study. These patients were newly treated and responded to 8-12 weeks of antidepressant treatment. Depressive symptoms, psychosocial functioning and quality of life were measured using standardized instruments. The study population was divided into three age groups: early adult (18-44 years old), middle adult (45-59 years old), and late adult (60-85 years old). RESULTS: Earlier age was associated with greater symptom severity, severer depressive symptoms in hypersomnia, concentration/decision making, negative view of the self, suicide ideation and restlessness, more impaired function, poorer satisfaction in social relationship and economic status, when compared to late adults with MDD (all P < 0.05). In the multivariable analyses, among the other variables, early age remained as an independent correlation of residual depressive severity (middle age vs. early age: OR = 0.631, 95%CI[0.462, 0.862]; old age vs. early age: OR = 0.521, 95%CI[0.348, 0.780]) and functional impairment. Comorbidity of physical illness had a negative contribution to all treatment outcomes. CONCLUSION: In first major depressive episode, early age was strongly associated with depressive severity and functional impairment after responding to antidepressant treatment. Early-life depression may be an indicator of MDD for poor clinical outcomes and high clinical burden.
AIMS & OBJECTIVES: Age differences exist in many aspects in patients with major depressive disorder (MDD). The present study aims to examine the effect of age on treatment outcomes in first-episode MDD. METHODOLOGY: A total of 982 first-episode major depressivepatients, who were above 18 years old and admitted in both psychiatric hospitals and units of general hospitals were recruited for the present study. These patients were newly treated and responded to 8-12 weeks of antidepressant treatment. Depressive symptoms, psychosocial functioning and quality of life were measured using standardized instruments. The study population was divided into three age groups: early adult (18-44 years old), middle adult (45-59 years old), and late adult (60-85 years old). RESULTS: Earlier age was associated with greater symptom severity, severer depressive symptoms in hypersomnia, concentration/decision making, negative view of the self, suicide ideation and restlessness, more impaired function, poorer satisfaction in social relationship and economic status, when compared to late adults with MDD (all P < 0.05). In the multivariable analyses, among the other variables, early age remained as an independent correlation of residual depressive severity (middle age vs. early age: OR = 0.631, 95%CI[0.462, 0.862]; old age vs. early age: OR = 0.521, 95%CI[0.348, 0.780]) and functional impairment. Comorbidity of physical illness had a negative contribution to all treatment outcomes. CONCLUSION: In first major depressive episode, early age was strongly associated with depressive severity and functional impairment after responding to antidepressant treatment. Early-life depression may be an indicator of MDD for poor clinical outcomes and high clinical burden.