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Late-life depression may differ from early-life depression in its phenomenology.
To investigate the effect of age on the phenomenology of major depression.
A systematic search was conducted in PubMed, Embase and PsycINFO for all studies examining the relation between age and phenomenology of major depression according to RDC, DSM and ICD criteria. Studies were included only if the age groups were compared at the single-item level using the 17-, 21- or 24-item versions of the Hamilton Rating Scale for Depression; a meta-analysis was done for each item of the 17-item scale.
Eleven papers met the inclusion criteria. Older depressed adults, compared with younger depressed adults, demonstrated more agitation, hypochondriasis and general as well as gastrointestinal somatic symptoms, but less guilt and loss of sexual interest.
The phenomenology of late-life depression differs only in part from that of early-life depression. Major depression in older people may have a more somatic presentation, whereas feelings of guilt and loss of sexual function may be more prevalent in younger people.
Four studies are reported in which an interview or questionnaire is used to measure the relation between behavioral inhibition, defined as consistent restraint in response to unfamiliar social or nonsocial stimuli, and adult mental health. In Study 1, undergraduates were tested using a retrospective self-report questionnaire. Those who reported more behaviors suggesting childhood inhibition also reported more mental health problems. Study 2 was an attempt to establish the postdictive validity of the measurement of childhood inhibition. College students and their parents completed the questionnaire independently and were in extremely strong agreement regarding the student's inhibited behaviors as a child. In Study 3, self-reported contemporary behaviors suggesting inhibition correlated with the retrospective self-report of inhibition. Both measures correlated with the State Anxiety Subscale of the State-Trait Anxiety Inventory and the Center for Epidemiologic Studies Depression Scale, and both accounted for unique variance in anxiety, but only contemporary inhibition accounted for unique variance in depression. In Study 4, adults who had been treated for panic disorder or depression were interviewed and reported more behaviors indicative of inhibition during childhood than did control subjects. These four studies support the usefulness of retrospective self-report as a measure of childhood inhibition and are compatible with the hypothesis that a tendency toward inhibited behavior in childhood or adulthood may be a risk factor for mental health problems.
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