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Single episode of major depressive disorder

First episode of recurrent mood disorder or distinct subtype of late-onset depression?
  • Giovanni B. Cassano
  • Hagop S. Akiskal
  • Mario Savino
  • Adalgisa Soriani
  • Laura Musetti
  • Giulio Perugi
Original Articles

Summary

Of 687 consecutive inpatients and outpatients with primary major depressive illness, 213 (31%) were categorized as single episode (SE) by DSM-III-R criteria. Systematic evaluation of familial, sociodemographic, temperamental and symptomatological characteristics permitted the nearly equal division of SE into two categories: a. early-onset (<45 years) “first episode” superimposed on either depressive or hyperthymic temperaments (against a bipolar and unipolar familial background), more severe depression, higher rates of suicide attempts, greater anxiety-somatization and psychotic tendencies, and with the potential for recurrence; b. late-onset (≥45 years) isolated episode (against an unipolar familial background) with greater life stressors, pursuing a protracted course with less likelihood of recurrence. In most other respects, early-onset SE was intermediate between recurrent major depression and lateonset SE. The implications of these findings for the now largely abandoned category of “involutional melancholia” are discussed.

Key words

Late-onset depression Single-episode depression Hyperthymic and depressive temperaments 

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Giovanni B. Cassano
    • 1
  • Hagop S. Akiskal
    • 2
  • Mario Savino
    • 1
  • Adalgisa Soriani
    • 1
  • Laura Musetti
    • 1
  • Giulio Perugi
    • 1
  1. 1.II Psychiatric Clinic, Institute of Clinical PsychiatryUniversity of PisaPisaItaly
  2. 2.University of California at San DiegoSan DiegoUSA

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