The role of psychosocial and biological variables in separating chronic and non-chronic major depression and early-late-onset dysthymia

J Affect Disord. 1994 Sep;32(1):1-11. doi: 10.1016/0165-0327(94)90055-8.

Abstract

Psychosocial (sociodemographic characteristics, loss and separation and family atmosphere in childhood, recent life events) and biological (family history, DST, TRH-test) variables were investigated in 180 patients with Major Depression (MD) and Dysthymic Disorder (DD). The aim of the study was to reveal certain differences between the chronic and non-chronic course of MD and the early- and late-onset subtypes of dysthymia. When comparing the two course patterns of MD, a higher rate of malignant tumours among first-degree relatives, a greater number of long-lasting stress situations before the index depressive episode, longer duration of the previous episodes, less frequent DST nonsuppression, and a blunted TSH response to TRH were found in patients with a chronic course of MD. Several factors seem to influence the course pattern of MD, or else the chronic form represents a subgroup within MD. The late-onset dysthymics were mainly women with a low level of education, a lower suicidal tendency, normal suppression in DST, and a lack of blunted TSH responses to TRH administration during the period of double depression. The early-onset dysthymics showed a higher number of persons who had never married, who presented a more traumatic and frustrating childhood background, and who had a higher rate of DST non-suppressors and blunted TSH responses after TRH administration during the period of their double depression. Our data suggest that late-onset dysthymia might be a biologically distinct subgroup of chronic depression.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child of Impaired Parents / psychology*
  • Child, Preschool
  • Chronic Disease
  • Comorbidity
  • Depressive Disorder / classification*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / genetics
  • Depressive Disorder / psychology
  • Dexamethasone*
  • Educational Status
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocortisone / blood
  • Life Change Events*
  • Male
  • Middle Aged
  • Neurocognitive Disorders / classification*
  • Neurocognitive Disorders / diagnosis
  • Neurocognitive Disorders / genetics
  • Neurocognitive Disorders / psychology
  • Recurrence
  • Risk Factors
  • Sex Factors
  • Social Environment*
  • Suicide, Attempted / psychology
  • Thyrotropin / blood
  • Thyrotropin-Releasing Hormone*

Substances

  • Thyrotropin-Releasing Hormone
  • Dexamethasone
  • Thyrotropin
  • Hydrocortisone