Single episode of major depressive disorder. First episode of recurrent mood disorder or distinct subtype of late-onset depression?

Eur Arch Psychiatry Clin Neurosci. 1993;242(6):373-80. doi: 10.1007/BF02190251.

Abstract

Of 687 consecutive inpatients and outpatients with primary major depressive illness, 213 (31%) were categorized as single episode (SE) by DSM-III-R criteria. Systematic evaluation of familial, sociodemographic, temperamental and symptomatological characteristics permitted the nearly equal division of SE into two categories: a. early-onset (< 45 years) "first episode" superimposed on either depressive or hyperthymic temperaments (against a bipolar and unipolar familial background), more severe depression, higher rates of suicide attempts, greater anxiety-somatization and psychotic tendencies, and with the potential for recurrence; b. late-onset (> or = 45 years) isolated episode (against an unipolar familial background) with greater life stressors, pursuing a protracted course with less likelihood of recurrence. In most other respects, early-onset SE was intermediate between recurrent major depression and late-onset SE. The implications of these findings for the now largely abandoned category of "involutional melancholia" are discussed.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Ambulatory Care
  • Bipolar Disorder / diagnosis
  • Depressive Disorder / classification
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Depressive Disorder, Major / classification
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / psychology
  • Female
  • Hospitalization
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Psychiatric Status Rating Scales
  • Recurrence
  • Sex Factors
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology
  • Temperament