Distinction of early- and late-onset depression in the elderly by their lifetime symptomatology

Objective. It has been proposed that early‐onset depression (EOD) and late‐onset depression (LOD) differ etiologically and phenomenologically. To validate the phenomenological distinction, the affective symptoms of elderly subjects with EOD and LOD were compared. Methods. Seventy‐one patients with age‐at‐onset of depression below 60 years (EOD) and 67 age‐matched patients with age‐at‐onset above 60 years (LOD) were consecutively recruited from the Departments of Psychiatry of the University of Mainz and the University of Bonn. To reduce the effect of interepisode variance of symptoms, we focused on the lifetime prevalence of different affective symptoms which were evaluated using the Composite International Diagnostic Interview (CIDI). Logistic regression analysis was performed to identify particular depressive symptoms which might discriminate EOD and LOD, and to account for possible sociodemographic differences between the two groups. Results and conclusion. Low spirits and feelings of worthlessness were more frequently found in EOD, they were sufficient discriminators to distinguish elderly subjects with EOD and LOD. This study provides further evidence for a phenomenological distinction between early‐ and late‐onset depression in the elderly. Copyright © 2000 John Wiley & Sons, Ltd.