Profile of Depression in Young, Middle-Aged and Elderly Patients

Abstract

epression has been defined generally as an affective condition, sometimes pathological, involving emotion of helplessness and hopelessness which can sometimes be overpowering and which is often accompanied by a general lowering of psychophysical activity. Depression is among the most prevalent of all psychiatric disorders. In fact, the rates of depression are so high that the World Health Organization (WHO) Global Burden of disease study ranked depression as the single most burdensome disease in the world in terms of total disability adjusted life years among people in midlife. Major depression is currently ranked fourth worldwide in disease burden, and it is expected to rank first in disease burden in high-income countries by the year 2020. Epidemiological studies have consistently shown that the prevalence of major depression is between 5% and 10% of people seen in primary care settings with women being twice as likely to be affected as men. Unlike most disabling physical diseases, mental illness begins very early in life. Half of all lifetime cases begin by age 14; three quarters have begun by age 24.Thus, mental disorders are really the chronic diseases of the young. For example, anxiety disorders often begin in late childhood, mood disorders in late adolescence, and substance abuse in the early 20's. Unlike heart disease or most cancers, young people with mental disorders suffer disability when they are in the prime of life, when they would normally be the most productive. Prevalence of mental illness increases from the youngest group (age 18-29) to the next-oldest age group (age 30-44) and then declines, sometimes substantially, in the oldest group (age 60 +) While depression can strike anyone at any time, research has identified that age is associated with an increased risk for depression. Most people experience their first episode of depression between the ages of 20 and 40. In fact, the average age of onset for depression is the mid-20s. Alarmingly, recent research shows that the average age of onset is decreasing with each generation. Children, adolescents and elderly persons often display unique symptoms of depression and have specific stressful events that predispose them to depression. Depression defined as recurrent disorder, consisting of discrete episodes of abnormal low mood, associated with functional impairment. The core symptoms of depression include depressed mood and/or loss of interest (anhedonia). Vegetative symptoms include alteration in sleep (insomnia or