Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-22T12:16:13.015Z Has data issue: false hasContentIssue false
  • English
  • Français

Lifetime Risk of Depression

Published online by Cambridge University Press:  06 August 2018

Hans-Ulrich Wittchen ,
Bärbel Knäuper  and
Ronald C. Kessler
Hans-Ulrich Wittchen*
Affiliation:
Max Planck Institute of Psychiatry, München, Germany
Bärbel Knäuper
Affiliation:
Max Planck Institute of Psychiatry, München, Germany
Ronald C. Kessler
Affiliation:
Institute for Social Research, University of Michigan, Ann Arbor, USA
*
Professor H.-U. Wittchen, Max Planck Institute of Psychiatry, Clinical Institute, Kraepelinstrasse 10, 80804 München, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

Over the past decade, major epidemiological studies have been conducted to determine the prevalence of depressive syndromes, primarily major depression or dysthymia. The highest prevalences occur in younger cohorts (18–29 years); considerably lower prevalences are found in older individuals (45 years and above), with the lowest in those aged 65 and older. Several studies have confirmed an increase in the cumulative lifetime estimates of major depression in successively younger birth cohorts during this century. At the same time, questions have been raised about the low prevalence of depression in the elderly, including the role of confounding factors (e.g. differential morbidity and response-biased memory). Standardised diagnostic assessment procedures may be insufficiently adapted for use in the elderly. It has also been recognised that a substantial number of elderly individuals suffer from clinically relevant symptoms of depression but do not meet the criteria for major depression. Future research will be required to elucidate fully the apparently changing rates of depression.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue S26: Depression: Challenge for the '90s , December 1994 , pp. 16 - 22
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Angst, J. (1992) Epidemiology of depression. Psychopharmacology, 10, S71–S74.Google Scholar
Angst, J. & Dobler-Mikola, A. (1985) The Zurich Study: VI. A continuum from depression to anxiety disorders? European Archives of Psychiatry and Neurological Sciences, 23, 179–186.Google Scholar
Angst, J., Merikangas, K., Scheidegger, P., et al (1990) Recurrent brief depression. A new subtype of affective disorder. Journal of Affective Disorders, 19, 87–98.Google Scholar
Bland, R. C., Newman, S. C. & Orn, H. (1988) Prevalence of psychiatric disorders in the elderly in Edmonton. Acta Psychiatrica Scandinavica, 338 (suppl. 338), 57–63.Google Scholar
Blazer, D. (1989a) Depression in late life. Current Opinions in Psychiatry, 2, 515–519.Google Scholar
Blazer, D. (1989b) Depression in the elderly. The New England Journal of Medicine, 320, 164–166.Google Scholar
Blazer, D. (1991) Clinical features in depression in old age: a case for minor depression. Current Opinions in Psychiatry, 4, 596–599.Google Scholar
Blazer, D. & Williams, C. D. (1980) Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry, 137, 439–444.Google Scholar
Blazer, D., Bachar, J. R. & Hughes, D. C. (1987) Major depression with melancholia: a comparison of middle-aged and elderly adults. Journal of the American Geriatrics Society, 35, 927–932.Google Scholar
Boyd, J. H. & Weissman, M. M. (1982) Epidemiology. In Handbook of Affective Disorders (ed. Paykel, E. S.), pp. 109–115. Edinburgh: Churchill Livingstone.Google Scholar
Burke, K. C., Burke, J. D. Jr, Rae, D. S., et al (1991) Comparing age at onset of major depression and other psychiatric disorders by birth cohorts in five US community populations. Archives of General Psychiatry, 48, 789–795.Google Scholar
Copeland, J. R. M., Kelleher, N. J., Kellett, J. M., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability. Psychological Medicine, 6, 439–444.CrossRefGoogle Scholar
Cross-National Collaborative Group (1992) The changing rate of major depression: cross-national comparisons. The Journal of the American Medical Association, 268, 3098–3105.Google Scholar
Crow, T. J. (1986) Secular changes in affective disorder and variations in the psychosis gene. Archives of General Psychiatry, 43, 1013–1018.Google Scholar
Fuhrer, R., Antonucci, T. C., Gagnon, M., et al (1992) Depressive symptomatology and cognitive functioning: an epidemiological survey in an elderly community sample in France. Psychological Medicine, 22, 159–172.Google Scholar
Gaitz, C. M. & Scott, J. (1972) Age and the measurement of mental health. Journal of Health and Social Behavior, 13, 55–67.Google Scholar
Garrison, C. Z., Addy, C. L., Jackson, K. L., et al (1992) Major depressive disorder and dysthymia in young adolescents. American Journal of Epidemiology, 135, 792–802.Google Scholar
Gershon, E. S., Homorit, J. H., Guroff, J. J., et al (1987) Birthcohort changes in manic and depressive disorders in relatives of bipolar and schizoaffective patients. Archives of General Psychiatry, 44, 314–319.Google Scholar
Henderson, A. S. (1986) Epidemiology of mental illness. In Mental Health in the Elderly: A Review of the Present State of Research (eds H. Häfner, G. Moschel & N. Sartorius), pp. 29–34. Berlin: Springer.Google Scholar
Henderson, A. S., Jorm, A. F. & Mackinnon, A. (1993) The prevalence of depressive disorders and the distribution of depressive symptoms in later life: a survey using draft ICD–10 and DSM–III–R. Psychological Medicine, 23, 719–729.Google Scholar
Katona, C. L. (1992) The epidemiology of depression in old age: the importance of physical illness. Clinical Neuropharmacology, 15 (suppl. 1), 281A–282A.Google Scholar
Kay, D. W. K., Henderson, A. S., Scott, R., et al (1985) Dementia and depression among the elderly living in the Hobart community: the effect of the diagnostic criteria on the prevalence rates. Psychological Medicine, 15, 771–788.CrossRefGoogle ScholarPubMed
Keller, M. B. & Shapiro, R. W. (1982) “Double depression”: superimposition of acute depressive episodes on chronic depressive disorders. American Journal of Psychiatry, 239, 438–442.Google Scholar
Kessler, R. C. & McRae, J. A. (1981) Trends in the relationship between sex and psychological distress: 1957–1976. American Sociological Review, 46, 443–453.Google Scholar
Kessler, R. C. & McRae, J. A. (1982) The effect of wives’ employment on the mental health of married men and women. American Sociological Review, 47, 216–227.Google Scholar
Kessler, R. C., McGonagle, K. A., Zhao, S., et al (1994a) Lifetime and 12-month prevalence of DSM–III–R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.Google Scholar
Kessler, R. C., McGonagle, K. A., Nelson, C. B., et al (1994b) Sex and depression in the National Comorbidity Survey II: cohort effects. Journal of Affective Disorders, 30, 15–26.CrossRefGoogle ScholarPubMed
Klerman, G. L., Lavori, P. W., Rice, J., et al (1985) Birth cohort trends in rates of major depressive disorder among relatives of patients with affective disorder. Archives of General Psychiatry, 42, 689–695.Google Scholar
Klerman, G. L. & Weissman, M. M. (1989) Increasing rates of depression. Journal of the American Medical Association, 261, 2229–2235.Google Scholar
Knäuper, B. (1994) Depressionsdiagnostik im Alter Verständuis und Verständlichkeit Standardisierter diagnostischer Interviewfragen. Regensburg: Roderer.Google Scholar
Knäuper, B. & Wittchen, H.-U. (1994) Diagnosing major depression in the elderly: evidence for response bias in standardised diagnostic interviews. Journal of Psychiatric Research, 28, 147–164.Google Scholar
Lewinsohn, P. M., Duncan, E. M., Stanton, A. K., et al (1986) Age at first onset for nonbipolar depression. Journal of Abnormal Psychology, 95, 378–383.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M., Rohde, P., Seeley, J. R., et al (1993) Age-cohort changes in the lifetime occurrence of depression and other mental disorders. Journal of Abnormal Psychology, 102, 110–120.Google Scholar
Nolen-Hoeksema, S. (1987) Sex differences in unipolar depression: evidence and theory. Psychological Bulletin, 101, 259–282.Google Scholar
Parmelee, P. A., Katz, I. R. & Lawton, M. P. (1989) Depression among institutionalized aged: assessment and prevalence estimation. Journal of Gerontology, 44, M22–M29.Google Scholar
Robins, L. N. & Regier, D. A. (eds) (1991) Psychiatric Disorder in America: The Epidemiologic Catchment Area Study. New York: Free Press.Google Scholar
Romanoski, A. J., Folstein, M. F. & Nestadt, G. (1992) The epidemiology of psychiatrist-ascertained depression and DSM–III depressive disorders. Results from the Eastern Baltimore Mental Health Survey Clinical Reappraisal. Psychological Medicine, 22, 629–655.CrossRefGoogle ScholarPubMed
Turrina, C., Siciliani, O., Dewey, M. E., et al (1992) Psychiatric disorders among elderly patients attending a geriatric medical day hospital: prevalence according to clinical diagnosis (DSM–III–R) and age category. International Journal of Geriatric Psychiatry, 7, 499–504.Google Scholar
Wacker, H. R., Müllejans, R., Klein, K. H., et al (1992) Identification of cases of anxiety disorders and affective disorders in the community according to ICD–10 and DSM–III–R by using the Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 2, 91–100.Google Scholar
Weissman, M. M., Myers, J. K. & Tischler, G. L. (1985) Psychiatric disorders (DSM–III) and cognitive impairment among the elderly in a US urban community. Acta Psychiatrica Scandinavica, 71, 366–379.Google Scholar
Wittchen, H.-U. (1988) Natural course and spontaneous remissions of untreated anxiety disorders: results of the Munich follow-up study (MFS). In Panic and Phobias 2. Treatments and Variables Affecting Course and Outcome in Panic and Phobias 2. Treatments and Variables Affecting Course and Outcome (eds J. Hand & H.-U. Wittchen), pp. 3–17. Berlin: Springer.Google Scholar
Wittchen, H.-U. & von Zerssen, D. (1988) Verläufe behandelter und unbehandelter Depressionen und Angststörungen. Eine klinischpsychiatrische und epidemiologische Verlaufsuntersuchung. Berlin: Springer.Google Scholar
Wittchen, H.-U., Robins, L. N., Cottler, L., et al (1991) Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI) – results of the multicentre WHO/ADAMHA Field Trials (wave I). British Journal of Psychiatry, 159, 645–653.Google Scholar
Wittchen, H.-U., Essau, C. A., von Zerssen, D., et al (1992) Lifetime and 6-month prevalence of mental disorders in the Munich Follow-up Study. European Archives of Psychiatry and Clinical Neuroscience, 241, 247–258.Google Scholar
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.