| 1. |
- Bogren, Mats, et al.
(author)
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Gender differences in subtypes of depression by first incidence and age of onset : a follow-up of the Lundby population
- 2018
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In: European Archives of Psychiatry and Clinical Neuroscience. - : Springer Science and Business Media LLC. - 0940-1334 .- 1433-8491. ; 268:2, s. 179-189
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Journal article (peer-reviewed)abstract
- The Lundby Study is a prospective mental health survey in a community population (N = 3563), in which data were collected in 4 waves of field-work between 1947 and 1997. We investigated gender differences during the follow-up in overall first incidence rates, ages of onset, and incidence by age of onset patterns, in different subtypes of depression. The overall incidence rate in females was higher than males for most subtypes of depression. However, for depression with melancholic and/or psychotic features, the overall first incidence rate did not differ significantly between the genders. The mean age of onset did not differ significantly between females and males in any of the depressive subtypes. Nevertheless, females and males had different first incidence rates by age of onset patterns for unipolar non-melancholic DSM-IV mood disorder and major depressive disorder (MDD), with a consistent gender incidence gap across all ages, but with the most conspicuous gender gap in middle age. The first incidence rates by age of onset patterns for DSM-IV MDD with melancholic and/or psychotic features did not differ significantly between the genders. The findings support that females are more prone than males to develop depression with medium severity, but no gender differences were found in melancholic and/or psychotic depression. The findings may support that unipolar non-melancholic depression and melancholic and/or psychotic depression represents different disorders. Tentative explanations for this are discussed.
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| 2. |
- Nöbbelin, Linnéa, et al.
(author)
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Incidence of melancholic depression by age of onset and gender in the Lundby population, 1947–1997
- 2023
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In: European Archives of Psychiatry and Clinical Neuroscience. - : Springer Science and Business Media LLC. - 0940-1334 .- 1433-8491. ; 273:5, s. 1163-1173
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Journal article (peer-reviewed)abstract
- Whether melancholic depression is a distinct syndrome or not has long been debated. There are few studies providing information about the epidemiology of melancholic depression. In this study, we investigate the incidence rates, overall as well as by gender and age of onset of melancholic depression according to Taylor and Fink and corresponding DSM–IV disorders: major depressive disorder (MDD) with melancholic specifier, MDD with psychotic features, MDD with postpartum debut and bipolar depression in the Lundby population. Incidence rates with 95% confidence intervals were calculated. The incidence rate of melancholic depression was 0.48 (CI 0.36–0.61) per 1000 person-years under risk. The rates of the corresponding DSM-IV disorders were as follows: MDD with melancholic specifier 0.38 (CI 0.27–0.49), MDD with psychotic features 0.13 (CI 0.07–0.21), MDD with postpartum debut 0.02 (CI 0.00–0.06) and bipolar depression 0.04 (CI 0.01–0.10). Females had a significantly higher incidence rate, with a peak in age group 40–49, in melancholic depression according to Taylor and Fink and MDD with melancholic specifier. There was no gender difference in incidence rates of MDD with psychotic features or bipolar depression. The diagnoses were set in retrospect and the number of subjects with MDD with postpartum debut and bipolar depression was low. Incidence of melancholia was low in the Lundby Study. There was a female preponderance to become melancholically depressed in line with research on undifferentiated depression.
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| 3. |
- Nöbbelin, Linnéa, et al.
(author)
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Is melancholia a distinct syndrome? : Recurrence, chronicity, and severity give evidence in the 50 year follow-up of the Lundby Study
- 2023
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In: Frontiers in Psychiatry. - 1664-0640. ; 14, s. 01-11
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Whether melancholia is a distinct syndrome has long been debated. One aspect of a valid syndrome is whether it allows for determination of a prognosis. The aim of this study is to investigate the course of melancholic depression versus non-melancholic depression with a focus on: (i) time to and probability of recovery from the first depressive episode, (ii) time to and risk of the first recurrence, (iii) rate of recurrence, (iv) time with depression or antidepressant medication, and (v) suicide risk.METHODS: The Lundby Study is a longitudinal community study on mental health that followed a geographically defined population ( N = 3,563) for up to 50 years, 1947-1997. Subjects with first onset depression were assessed as melancholic ( N = 46) or non-melancholic ( N = 381) using the DSM-IV melancholic specifier. These diagnoses were made in retrospect using all available information from semi-structured interviews by psychiatrists, key informants, registers, and patient records. RESULTS: We found no significant difference between melancholic- and non-melancholic depression in time to and probability of recovery from the first depressive episode. The time to first recurrence was shorter in melancholic than in non-melancholic depression and the risk of first recurrence for the melancholic group was 2.77 (95% confidence interval [CI] 1.83-4.20) times the risk in the non-melancholic group. The median rate of recurrence was higher in the melancholic group, at 0.19 recurrences per year at risk (interquartile range [IQR] 0.08-0.47), compared to the non-melancholic group, at 0.10 recurrences per year at risk (IQR 0.05-0.21) ( p < 0.03). The median percentage of time being depressed or on antidepressant medication was higher in the melancholic group, 17% (IQR 3-20%), compared to the non-melancholic group, 8% (IQR 7-33%) ( p < 0.001). The risk of suicide was higher in the melancholic group, hazard ratio 4.13 (95% CI 1.49-11.48, p < 0.01). DISCUSSION: To conclude, melancholic depression had a more recurrent, chronic, and severe course with a higher suicide risk than did non-melancholic depression in the Lundby population. Although our use of retrospective diagnosis might limit interpretation of results, the findings indicate that melancholia may be useful in determining prognosis and may be a valid psychopathological syndrome.
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| 4. |
- Nöbbelin, Linnéa, et al.
(author)
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Risk factors for recurrence in depression in the Lundby population, 1947–1997
- 2018
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In: Journal of Affective Disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 288, s. 125-131
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Journal article (peer-reviewed)abstract
- Background Depression is a common disorder in both men and women, and the recurrence rate is high. The aim of this study was to identify risk factors for recurrence in depression in the Lundby Study. Methods The Lundby Study is a community-based longitudinal study with focus on mental health. The study started in 1947 and three follow-ups have been carried out since, the last one in 1997. The population consists of 3563 subjects. Data from 508 subjects afflicted by depression was gathered. Premorbid factors (gender, socioeconomic status, marital status, personality and heredity) and factors related to the first depressive episode (age, degree of impairment and melancholic depression) were investigated regarding their influence on the risk for recurrence in depression. Multiple logistic regression was used in the calculations. Results Risk factors associated with recurrent depression were melancholic depression at first onset (OR 3.52 [95% CI 1.62–7.66, p < 0.001]), young age as compared to old age at first onset (OR 0.51 [95% CI 0.28–0.92, p = 0.03]) and a premorbid nervous/tense personality (OR 1.77 [95% CI 1.22–2.56, p < 0.01]). Demographic factors, including gender, had no effect on the odds of recurrence. Limitations The Lundby Study spans over 50 years, making the results vulnerable to changes in diagnostic regimes and recall bias. Conclusion Melancholia at onset, regardless of severity of symptoms, had the greatest impact on the risk of recurrence in depression in the Lundby Study. Information about risk factors for recurrence in depression are useful in offering effective preventive measures in the form of psychotropic drugs and psychotherapy, and deciding the length of follow-up.
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