Background. We pursue an observation that age may influence the clinical fe
atures of melancholia and, in particular, psychomotor disturbance.
Methods. Two large clinical databases were amalgamated allowing the clinica
l features of 124 depressed subjects meeting DSM-III-R and clinical criteri
a for melancholia to be contrasted with 218 subjects diagnosed as having a
non-melancholic depression by both criteria sets. Psychomotor disturbance w
as assessed by the CORE measure and by seven classical endogeneity symptoms
of melancholia which, when summed, created a ENDOG score.
Results. There was no impact of age on ENDOG scores in either the melanchol
ics or non-melancholics. In the melancholics, increasing age was associated
with increasing CORE scores and with agitation scale scores in particular.
In a set of discriminant function analyses seeking to identify the compara
tive utility of a set of predictors of melancholic (versus non-melancholic)
groups, age was significant, and while CORE and ENDOG scores were individu
al predictors, their combined entry established that the CORE score alone m
ade the ENDOG score redundant, and that the addition of age then made littl
e impact.
Conclusions. Melancholia appears to have a later age of onset than non-mela
ncholic depression, while its phenotypic expression appears to change with
age, with psychomotor disturbance being more distinct in older subjects. Su
ch an effect may have a number of clinical implications, including possible
differential effects of varying antidepressant treatments.