Depressão maior de início precoce ou tardio em idosos : um estudo comparativo

Abstract

Introduction : Major depression is one of the most relevant mental disorders in elderly. Some authors propose that the distinction between cases of early-onset and late-onset major depression is justified by differences in etiology, clinical picture and comorbidities. Such differences are still not clarified enough, and some disagreement among studies does exist. Objectives : To investigate the distinctive characteristics between elderly with early-onset and late-onset major depression with respect to sociodemographic factors, self-perceived health, cardiovascular risk factors, cognitive deficit, family history of depression, depressive symptoms, melancholic features, suicide risk and alcohol abuse/dependence. Methods : Cross-sectional, descriptive and analytic study, with prospective data collection, in an aleatory sample of 348 elderly (≥60 years old) of the Health Family Strategy, of which were identified 90 cases of DSM-IV unipolar major depression; subjects were divided according to early or late (≥60) age at onset of depression. Results : The prevalence of major depression in the whole sample was 25,86%. Depressive subjects were mainly of early-onset (69,14%) and of female sex (74,4%); the mean age in years was higher in the late-onset major depression group (p= 0,028); the groups did not differ with respect to the other evaluated factors; after multivariate analysis there was a trend toward a negative association between suicide risk and late-onset depression. Conclusion : The early or late age at onset of depressive symptoms was not associated with distinctive profiles, neither with respect to clinical picture, nor with respect to the risk factors. The results of this paper give support to the hypothesis that early and late-onset major depressive disorders are clinically undistinguishable and do not represent distinct pathologies or subtypes.