Depression in Singapore: failure to demonstrate an age effect on clinical features

Objectives Studies comparing older and younger depressed patients have vari ably identified differing and similar clinical feature patterns, an inconsi stency requiring clarification and explanation. If influential, age may hav e a true phenotypic effect or be a secondary influence reflecting depressiv e sub-type differences. If age is primarily influential, then, after contro lling for depressive sub-type differences its effect should impact on clini cal features - even in non-western regions. Methods We therefore undertook a study in Singapore, comparing 42 elderly a nd 28 younger patients of a Singapore psychiatric hospital, and with the di agnostic sub-type profile similar across the age-based groups. Results Despite the elderly group being some 35 years older, both at first episode and when surveyed, and having a distinctly higher rate of physical disorders, few clinical differences were identified. While the elderly grou p reported a less severe depressed mood and more 'somatic' symptoms, analys es indicated that such differences were accounted for by education and lang uage factors, and were compatible with the view that Chinese subjects histo rically report depression more 'somatically'. Conclusion We conclude that, in a non-western, largely Chinese sample of de pressed patients, few differences in the phenotypic expression of depressio n were identified, perhaps reflecting similar distributions of depressive s ub-types across the groups, an issue which may have muddied interpretation of western studies. Copyright (C) 2001 John Wiley & Sons, Ltd.