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Depression in later life: three etiologically different subgroups
M D Van den Berg1, A J Oldehinkel, A L Bouhuys
1Department of Social Psychiatry, University Hospital Groningen, The Netherlands. m.d.van.den.berg@med.rug.nl
Background:
Various studies support the notion that early onset depression and late onset depression have different etiological pathways. Late onset depression has been found to be a heterogeneous group. This study attempts to divide the late onset group in two subgroups with different aetiology and find evidence for the vascular depression hypothesis.
Methods:
Subjects were 132 depressed elderly persons from the general population, general practitioners and mental health care outpatient clinics. Sixty-four had early-onset depression (< 60), 69 had late-onset depression (> or = 60). The latter group was divided into subjects with (n = 15) and without (n = 15) severe life stress. The groups were compared with respect to a variety of variables including vascular risk factors
Results:
Early-onset depression was associated with neuroticism and parental history. Subjects with late-onset depression and no severe life stress had higher vascular risk factors than whose depression was preceded by a severe stressor did.
Conclusions:
Our findings suggest that late life depression can be divided into subgroups with different etiological pathways: (1) early-onset with longstanding psychobiological vulnerability; (2) late-onset as reaction to severe life stress; and (3) late-onset with vascular risk factors.