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Age and recognition of depression: implications for a cohort effect in major depression

Published online by Cambridge University Press:  09 July 2009

Deborah Hasin*
Affiliation:
College of Physicians and Surgeons and School of Public Health (Division of Epidemiology), Columbia University, and New York State Psychiatric Institute, New York, USA
Bruce Link
Affiliation:
College of Physicians and Surgeons and School of Public Health (Division of Epidemiology), Columbia University, and New York State Psychiatric Institute, New York, USA
*
1Address for correspondence: Dr Deborah Hasin, New York State Psychiatric Institute, Box 123, 722 W. 168th Street, New York, New York 10032, USA.

Synopsis

Studies relying on subjects' retrospective reports have recently been interpreted as indicating that individuals born since World War II are at increased risk for a diagnosis of lifetime major depression. Examining the validity of this ‘cohort effect’ is essential, given the potential importance of such a phenomenon for research and policy. Among a number of artefactual explanations for the cohort effect is the possibility that older individuals are less likely to recognize depression as a mental disorder, and hence are less likely to remember depressive episodes as such, or to report these episodes in interviews on mental health. To test whether age was related to the recognition of major depression as a mental problem, we analysed responses from 152 randomly selected community residents on whether a vignette describing DSM-III major depression represented a psychological or emotional problem. Older respondents were much less likely to characterize major depression this way, even controlling for other factors. Such an age effect may provide a partial explanation for the apparent cohort effect, although the issue is complex and further research is needed.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1988

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References

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). APAWashington, D.C.Google Scholar
Hagnell, O., Lanke, J., Rorsman, B. & Ojesjo, L. (1982). Are we entering an age of melancholy? Depressive illnesses in a prospective epidemiological study over 25 years: the Lundby Study, Sweden. Psychological Medicine 12, 279289.CrossRefGoogle Scholar
Harrell, F. E. (1985). Logistic procedure. In SUGI Supplemental Users Guide (ed. Joyner, S. P.), pp. 181192. SAS Institute: Cary.Google Scholar
Kessler, R., Brown, R. & Broman, C. (1981). Sex differences in psychiatric help seeking: evidence from four large-scale surveys. Journal of Health and Social Behavior 22, 4763.CrossRefGoogle ScholarPubMed
Klerman, G. L., Lavori, P. W., Rice, J., Reich, T., Endicott, J., Andreasen, N. C, Keller, M. B. & Hirschfeld, R. M. A. (1985). Birth-cohort trends in rates of Major Depressive disorder among relatives of patients with affective disorder. Archives of General Psychiatry 42, 689693.CrossRefGoogle ScholarPubMed
Lavori, P. W., Klerman, G. L., Keller, M. B., Reich, T., Rice, J. & Endicott, J. (1987). Age-period-cohort analysis of secular trends in onset of major depression: findings in siblings of patients with major affective disorders. Journal of Psychiatric Research 21, 2335.CrossRefGoogle Scholar
Link, B. & Dohrenwend, B. P. (1980). Formulation of hypotheses about the ratio of untreated to treated cases in the true prevalence studies of functional psychiatric disorder in adults in the United States. In Mental Illness in the United States (ed. Dohrenwend, B. P., Dohrenwend, B. S., Gould, M. S. Link, B., Neugebauer, R. and Wunsch-Hitzig, R.), pp. 133144. Praeger: New York.Google Scholar
Merikangas, K., Prusoff, B. & Weissman, M. M. (1984). Reliability of family history data in reporting major depression and age of onset.Presented at the McArthur Foundation Conference on the Cohort Effect,March 16, 1984,Boston, Massachusetts.Google Scholar
Rice, J. P., Endicott, J., Knesevich, M. A. & Rochberg, N. (1988). The estimation of diagnostic sensitivity using stability data: an application to major depressive disorder. Journal of Psychiatric Research 21, 337345.CrossRefGoogle Scholar
Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, J. D. & Regier, D. A. (1984). Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry 41, 949958.CrossRefGoogle ScholarPubMed
Shapiro, S., Skinner, E. A., Kessler, L. G., Von Korff, M., German, P. S., Tischler, G. L., Leaf, P. J., Benham, L., Cottler, L., & Regier, D. A. (1984). Utilization of health and mental health services. Three epidemiological catchment area sites. Archives of General Psychiatry 41, 971978.CrossRefGoogle ScholarPubMed
Spiro, H. R., Siassi, I. & Crochetti, G. (1973). Ability of the public to recognize mental illness: an issue of substance and an issue of meaning. Social Psychiatry 8, 3236.CrossRefGoogle Scholar
Srole, L. & Fischer, A. K. (1980). The Midtown Manhattan longitudinal study vs. ‘The “Mental Paradise Lost” doctrine’: a controversy joined. Archives of General Psychiatry 37, 209221.CrossRefGoogle ScholarPubMed
Star, S. (1955). The public's ideas about mental illness. National Opinion Research Center, mimeographed.Google Scholar
Veroff, J., Kulka, R. & Douvan, E. (1981). Mental Health in America: Patterns of Help Seeking from 1957 to 1976. Basic Books: New York.Google Scholar