INCREASED RATE OF PSYCHOSIS AND PSYCHOMOTOR CHANGE IN DEPRESSION WITHAGE

Background. We examined the phenomenology of depression in younger (< 60 years old) versus older(greater than or equal to 60 years) subjects and, more specifically, the interaction between age and psychomotor d isturbance associated with depression. Method. Two hundred and eighty- five patients with a DSM-III-R diagnosis of unipolar major depression referred to a mood disorders unit were assessed using the CORE rating scale, a sign-based system for defining melancholia. Subjects were als o assessed using the Hamilton Rating Scale for Depression, Zung Depres sion Scale, Newcastle Endogenous Depression Inventory and the General Health Questionnaire. Results. The total CORE score (and each of its s ubscales) was found to interact with age. Rates of psychotic and melan cholic depression increased with age. Elderly depressives suffered mor e severe depression (higher HRSD scores), appetite loss and weight los s. Level of psychomotor disturbance and rates of psychosis did not dif fer between those elderly subjects with an early onset (before the age of 60 years) and those with a late onset (at or after 60 years) of de pression. Conclusions. There appear to be robust phenomenological diff erences in depression between older and younger subjects. The associat ion between age and psychomotor change may assist our understanding of the neurobiology of depression.