Age-related differences in the symptomatic expression of major depression

Hamilton Rating Scale for Depression and Beck Depression Inventory results were examined in a consecutive series of 174 female and 83 male patients, ranging in age from 18 to 81 years, admitted to a psychiatric hospital with a diagnosis of major depression. Items on the two scales were examined to determine the relationship between age and the symptomatic expression of major depression. Overall scores on the Hamilton scale revealed no relationship with age, but scores for males on the Beck Depression Inventory were negatively associated with age. In addition, the most prevalent types of depressive symptoms showed significant correlations with age. Items related to low self-esteem, such as guilt, sense of failure, self-accusations, and thoughts of suicide, showed a negative relationship with age for both males and females. It is possible that psychological maturation or other age-related factors reduce vulnerability to low self-esteem during episodes of clinical depression; however, selection bias or a cohort effect cannot be ruled out with the current methodology.