Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-20T01:58:55.381Z Has data issue: false hasContentIssue false
  • English
  • Français

Examining variation in depressive symptoms over the life course: a latent class analysis

Published online by Cambridge University Press:  24 February 2012

B. Mezuk  and
K. S. Kendler
B. Mezuk*
Affiliation:
Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA, USA Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
K. S. Kendler
Affiliation:
Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
*
*Address for correspondence: Dr B. Mezuk, Department of Epidemiology and Community Health, Virginia Commonwealth University, PO Box 980212, Richmond, VA 23298, USA. (Email: bmezuk@vcu.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Older adults have the lowest prevalence and incidence of major depressive disorder, although it has been hypothesized that this finding is due in part to differences in expression of psychopathology in later life. The aim of this study was to examine variation in depressive symptomatology in the general population across the lifespan.

Method

Data came from three sites of the Epidemiologic Catchment Area (ECA) Project (n=10 529). Depressive symptoms during the past 6 months were assessed using the Diagnostic Interview Schedule (DIS). Latent class analysis (LCA) was used to identify homogeneous groups of depressive symptomatology based on 16 individual symptoms, and to examine variation in the prevalence and composition of depression classes across age groups.

Results

The DIS symptoms fit a four-class model composed of non-depressed (83.2%), mild depression (11.6%), severe depression (1.9%), and despondent (3.2%) groups. Relative to the non-depressed class, older age was inversely associated with being in the mild or severe depression class. The profile of the latent classes was similar across age groups with the exception of the despondent class, which was not well differentiated among the youngest adults and was not inversely associated with age.

Conclusions

The symptom profiles of depression are similar across age with the exception of the despondent class, which is more differentiated from severe depression among older adults. The findings demonstrate the benefit of examining individual symptoms rather than broad symptom groups for understanding the natural history of depression over the lifespan.

Keywords

Agingdepressionepidemiologygeriatric psychiatrylatent class analysis
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 10 , October 2012 , pp. 2037 - 2046
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bandeen-Roche, KJ, Miglioretti, DL, Zeger, SL, Rathouz, PJ (1997). Latent variable regression for multiple discrete outcomes. Journal of the American Statistical Association 92, 1375–1386.CrossRefGoogle Scholar
Blanchflower, DG, Oswald, AJ (2008). Is well-being U-shaped over the life cycle? Social Science and Medicine 66, 1733–1749.CrossRefGoogle ScholarPubMed
Blazer, DG, Bachar, JR, Manton, KG (1986). Suicide in late life: review and commentary. Journal of the American Geriatrics Society 34, 519–525.CrossRefGoogle Scholar
Chen, L-S, Eaton, WW, Gallo, JJ, Nestadt, G (2000). Understanding the heterogeneity of depression through the triad of symptoms, course, and risk factors: a longitudinal, population-based study. Journal of Affective Disorders 59, 1–11.CrossRefGoogle ScholarPubMed
Cross-National Collaborative Group (1992). The changing rate of major depression. Journal of the American Medical Association 268, 3098–3105.CrossRefGoogle Scholar
Eaton, WW, Anthony, JC, Gallo, J, Cai, G, Tien, A, Romanoski, A, Lyketsos, C, Chen, LS (1997). Natural history of Diagnostic Interview Schedule/DSM-IV major depression: the Baltimore Epidemiologic Catchment Area follow-up. Archives of General Psychiatry 54, 993–999.Google Scholar
Eaton, WW, Dryman, A, Sorenson, A, McCutcheon, A (1989). DSM-III major depressive disorder in the community. A latent class analysis of data from the NIMH epidemiologic catchment area programme. British Journal of Psychiatry 155, 48–54.Google Scholar
Eaton, WW, Kalaydjian, A, Sharfstein, DO, Mezuk, B, Ding, Y (2007). Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981–2004. Acta Psychiatrica Scandinavica 116, 182–188.Google Scholar
Eaton, WW, Neufeld, K, Chen, LS, Cai, G (2000). A comparison of self-report and clinical diagnostic interviews for depression: Diagnostic Interview Schedule and Schedules for Clinical Assessment in Neuropsychiatry in the Baltimore Epidemiologic Catchment Area follow-up. Archives of General Psychiatry 57, 217–222.CrossRefGoogle ScholarPubMed
Eaton, WW, Shao, H, Nestadt, G, Lee, HB, Bienvenu, OJ, Zandi, P (2008). Population-based study of first onset and chronicity in major depressive disorder. Archives of General Psychiatry 65, 513–520.Google Scholar
Flint, AJ (2002). The complexity and challenge of non-major depression in late life. American Journal of Geriatric Psychiatry 10, 299–232.CrossRefGoogle ScholarPubMed
Gallo, JJ, Anthony, JC, Muthen, BO (1994). Age differences in the symptoms of depression: a latent trait analysis. Journal of Gerontology 49, 251–264.CrossRefGoogle ScholarPubMed
Geiselmann, B, Bauer, M (2000). Subthreshold depression in the elderly: qualitative or quantitative distinction? Comprehensive Psychiatry 41, 32–38.CrossRefGoogle ScholarPubMed
Giuffra, LA, Risch, N (1994). Diminished recall and the cohort effect of major depression: a simulation study. Psychological Medicine 24, 375–383.CrossRefGoogle ScholarPubMed
Hybels, CF, Blazer, DG, Landerman, LR, Steffens, DC (2011). Heterogeneity in symptom profiles among older adults diagnosed with major depression. International Psychogeriatrics. Published online: 18 January 2011. doi:10.1017/S1041610210002346.CrossRefGoogle Scholar
Hybels, CF, Blazer, DG, Pieper, CF, Landerman, LR, Steffens, DC (2009). Profiles of depressive symptoms in older adults diagnosed with major depression: latent cluster analysis. American Journal of Geriatric Psychiatry 17, 387–396.CrossRefGoogle ScholarPubMed
Kendler, KS, Eaves, LJ, Walters, EE, Neale, MC, Heath, AC, Kessler, RC (1996). The identification and validation of distinct depressive syndromes in a population-based sample of female twins. Archives of General Psychiatry 53, 391–399.Google Scholar
Kessler, RC, Amminger, GP, Aguilar-Gaxiola, S, Alonso, J, Lee, S, Ustun, TB (2007). Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry 20, 359–264.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication. Journal of the American Medical Association 289, 3095–3105.CrossRefGoogle ScholarPubMed
Kessler, RC, Birnbaum, H, Bromet, E, Hwang, I, Sampson, N, Shahly, V (2010). Age differences in major depression: results from the National Comorbidity Survey Replication. Psychological Medicine 40, 225–237.CrossRefGoogle ScholarPubMed
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617–627.CrossRefGoogle ScholarPubMed
Kessler, RC, Foster, C, Webster, PS, House, JS (1992). The relationship between age and depressive symptoms in two national surveys. Psychology and Aging 7, 119–126.Google Scholar
Kouzis, A, Eaton, WW, Leaf, PJ (1995). Psychopathology and mortality in the general population. Social Psychiatry and Psychiatric Epidemiology 30, 165–170.Google Scholar
Lavretsky, H, Kumar, A (2002). Clinically significant non-major depression: old concepts, new insights. American Journal of Geriatric Psychiatry 10, 239–255.Google Scholar
Lux, V, Kendler, KS (2010). Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria. Psychological Medicine 40, 1679–1690.Google Scholar
McCutcheon, A (1987). Latent Class Analysis. Sage Publications: Beverly Hills, CA.CrossRefGoogle Scholar
Middleton, N, Gunnell, D, Whitley, E, Dorling, D, Frankel, S (2001). Secular trends in antidepressant prescribing in the UK, 1975–1998. Journal of Public Health Medicine 23, 262–267.Google Scholar
Nguyen, HT, Zonderman, AB (2006). Relationship between age and aspects of depression: consistency and reliability across two longitudinal studies. Psychology and Aging 21, 119–126.Google Scholar
Patten, SB (2009). Accumulation of major depressive episodes over time in a prospective study indicates that retrospectively assessed lifetime prevalence estimates are too low. BMC Psychiatry 9, 19.CrossRefGoogle Scholar
Patten, SB, Gordon-Brown, L, Meadows, G (2010). Simulation studies of age-specific lifetime major depression prevalence. BMC Psychiatry 10, 85.CrossRefGoogle ScholarPubMed
Regier, DA, Myers, JK, Kramer, M, Robins, LN, Blazer, DG, Hough, RL, Eaton, WW, Locke, BZ (1984). The NIMH Epidemiologic Catchment Area Program. Historical context, major objectives, and study population characteristics. Archives of General Psychiatry 41, 934–941.CrossRefGoogle ScholarPubMed
Robins, LN, Helzer, JE, Croughan, J, Ratcliff, KS (1981). National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Archives of General Psychiatry 38, 381–389.CrossRefGoogle ScholarPubMed
Robins, LN, Helzer, JE, Ratcliff, KS, Seyfried, W (1982). Validity of the diagnostic interview schedule: DSM-III diagnoses. Psychological Medicine 12, 855–870.Google Scholar
Sullivan, PF, Kessler, RC, Kendler, KS (1998). Latent class analysis of lifetime depressive symptoms in the National Comorbidity Survey. American Journal of Psychiatry 155, 1398–1406.CrossRefGoogle ScholarPubMed
Vannoy, SD, Tai-Seale, M, Duberstein, P, Eaton, LJ, Cook, MA (2011). Now what should I do? Primary care physicians' respondents to older adults expressing thoughts of suicide. Journal of General Internal Medicine 26, 1005–1011.Google Scholar
Wells, JE, Horwood, LJ (2004). How accurate is recall of key symptoms of depression? A comparison of recall and longitudinal reports. Psychological Medicine 34, 1001–1011.CrossRefGoogle ScholarPubMed
Supplementary material: File

Mezuk supplementary material

Tables.docx

Download Mezuk supplementary material(File)
File 16.7 KB