Course profiles of early- and adult-onset depression

The age of onset of major depression may produce divergent profiles of recovery after treatment.

Symptom level and course trajectories of with early- and adult-onset of major depression were followed prospectively over 2 years in 62 adult outpatients who recovered from DSM-III-R unipolar major depression after cognitive behavior therapy. We compared individuals with depression onset before age 20 (n = 31) with those with onset after age 20 (n = 31), controlling for current age, education, and history of depression, and accounting for their return to mental health treatment. Participants completed psychiatric and psychosocial assessments before and after treatment, and every 6 months for 2 years post-treatment. We analyzed severity and changes of weekly depressive symptoms to construct profiles of recovery for the early- and adult-onset groups.

Our data indicated: (a) on average, the early-onset group experienced consistently more depressive symptoms than the adult-onset group; (b) the pattern of symptoms remained level for both groups during the 2-year follow-up; (c) both groups maintained parallel and stable course profiles over the 2-year follow-up; and, (d) early age of onset was associated with higher rate of depressive relapse.

Accuracy of the ratings of depressive symptoms may have been limited by the retrospective nature of the psychiatric status ratings.

Results suggest that among our recovered participants, early age of onset is associated with shorter time to relapse, more residual symptoms over the follow-up, and a stable and linear course of residual symptoms during the 2-year follow-up.