Late-life depression: the differences between early- and late-onset illness in a community-based sample
Late-life depression: the differences between early- and late-onset illness in a community-based sample
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DOI：
10.1002/gps.1428
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发表时间：
2006-01-01
影响因子：
4
通讯作者：
Heeren, TJ
中科院分区：
文献类型：
--
作者：
Janssen, J;Beekman, ATF;Heeren, TJ
背景：一些研究已经描述了早发和晚发老年抑郁症患者的病因和临床差异。虽然大多数研究都是在临床样本中进行的，但尚不清楚这些发现是否可以推广到整个老年人群。本研究的目的是比较早发性（EOD）和晚发性（LOD）抑郁症在以社区为基础的sample.Methods大（n = 3107）的老年人（55-85岁）在荷兰的代表性样本。两阶段筛选程序，以确定老年人与MDD。采用流行病学研究中心抑郁量表（CES-D）作为筛选工具，采用诊断性访谈量表（DIS）诊断MDD。对90例早发性抑郁症和39例晚发性抑郁症患者进行了调查。两组之间的家族精神病史、血管病理学和应激性早期和晚期生活事件没有差异。EOD受试者往往有双重抑郁症和更多的anxious.Conclusions在社区为基础的样本，我们没有发现明确的差异，EOD和LOD之间的病因和现象。这种与临床样本报告的差异可能是由于临床研究中的选择偏倚。因此，所有患有晚年抑郁症的患者都应该对心理和躯体风险因素进行诊断性检查，并相应地集中治疗干预。版权所有（c）2005年约翰威利父子有限公司。
Background Several studies have described etiological and clinical differences between elderly depressed patients with early onset of their illness compared to late onset. While most studies have been carried out in clinical samples it is unclear whether the findings can be generalized to the elderly population as a whole. The aim of this study was to compare early-onset (EOD) and late-onset (LOD) depressive illness in a community-based sample.Methods Large (n = 3107) representative sample of older persons (55-85 years) in the Netherlands. Two-stage screen procedure to identify elderly with MDD. The Center for Epiderniologic Studies Depression scale (CES-D) was used as a screen and the Diagnostic Interview Schedule (DIS) to diagnose MDD. Data on 90 older persons with early-onset depression and 39 with late-onset depression were available.Results Those with LOD were older, and more often widowed. Family psychiatric history, vascular pathology, and stressful early and late life events did not differ between groups. EOD subjects had more often double depression and more anxiety.Conclusions In a community-based sample we did not detect clear differences in etiology and phenomenology between EOD and LOD. This discrepancy with reports from clinical samples could be due to selection bias in clinical studies. Consequently, all patients with late-life depression deserve a diagnostic work-up of both psychosocial and somatic risk factors and treatment interventions should be focused accordingly. Copyright (c) 2005 John Wiley & Sons, Ltd.