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Effects of age and gender on the classification and phenomenology of unipolar depression


Michael Maes MD, PhD, Professor of Psychiatry, Department of Psychiatry, University Hospital of Maastricht, Postbus 5800, 6202 AZ Maastricht, the Netherlands. Tel: 0031 43 3781025; Fax: (the Netherlands): 0031 43 3781026, (Belgium): 0031 89 723531; E-mail:


Aim: The aim of the present study was to examine the effects of age and gender on depressive classification and phenomenology in unipolar depressed in-patients.

Methods: The authors have assessed 14 items relevant to depressive symptomatology from the Structured Clinical Interview for DSM-III (SCID) and the Hamilton Depression Rating Scale (HDRS) in 180 depressed in-patients.

Results: Melancholia was significantly more prominent in older depressed patients (≥ 55 years), whereas minor depression (i.e. adjustment disorder with depressed mood and dysthymic disorder) in younger (< 55 years) depressed subjects. Older depressed subjects exhibited significantly more anorexia/weight loss, non-reactivity, depressed mood, loss of interest, early morning awakening, loss of energy, somatic anxiety, loss of insight, psychotic symptoms and retardation than younger depressed people. Male depressed subjects showed significantly more loss of interest, suicidal ideation and agitation than their female counterparts. Psychomotor disorders, a distinct quality of mood and early morning awakening were characteristics of older depressed males, while diurnal variation occurred more frequently in older depressed females.

Conclusion: It is concluded that increasing age in unipolar depression may be accompanied by an increase in severity of illness, increased frequency of some melancholic symptoms, particularly in men and a higher frequency of major depression in women and of melancholia in men.