Acta Neuropsychiatrica 2002: 14: 29–35 Copyright C Acta Neuropsychiatrica 2002 Printed in Denmark. All rights reserved ISSN 0924-2708 Effects of age and gender on the classification and phenomenology of unipolar depression M. Maes. Effects of age and gender on the classification and M. Maes phenomenology of unipolar depression. Department of Psychiatry, University of Maastricht, Maastricht, Acta Neuropsychiatrica 2002: 14:29–35. C Blackwell Munksgaard the Netherlands 2002 Aim: The aim of the present study was to examine the effects of age and gender on depressive classification and phenomenology in unipolar depressed in-patients. Methods: The authors have assessed 14 items relevant to depressive symptomatology from the Structured Clinical Interview for DSM-III (SCID) and the Hamilton Depression Rating Scale (HDRS) in 180 depressed in-patients. Results: Melancholia was significantly more prominent in older depressed patients ( 55years), whereas minor depression (i.e. adjustment disorder with depressed mood and dysthymic disorder) in younger ( 55years) depressed subjects. Older depressed subjects exhibited significantly more anorexia/weight loss, non-reactivity, depressed mood, loss of interest, early morning awakening, loss of energy, somatic anxiety, loss of insight, psychotic symptoms and retardation than younger depressed people. Male depressed subjects Key words: depression; phenomenology; age; gender; DSM- showed significantly more loss of interest, suicidal ideation and III; SCID; melancholia; minor depression agitation than their female counterparts. Psychomotor disorders, a Correspondence: Michael Maes MD, PhD, Professor of distinct quality of mood and early morning awakening were Psychiatry, Department of Psychiatry, University Hospital of characteristics of older depressed males, while diurnal variation Maastricht, Postbus 5800, 6202 AZ Maastricht, the occurred more frequently in older depressed females. Netherlands. Tel: 0031433781025; Fax: (the Netherlands): 0031433781026, (Belgium): 003189723531; Conclusion: It is concluded that increasing age in unipolar E-mail: crc-mh/online.be depression may be accompanied by an increase in severity of illness, http://www.marquiswhoswho.net/MMAES increased frequency of some melancholic symptoms, particularly in men and a higher frequency of major depression in women and of melancholia in men. Accepted for publication 3 December, 2001 Introduction There is considerable interest in validating the existence of various subtypes of unipolar de- pression. Both the Research Diagnostic Criteria (RDC) (1,2) and the Diagnostic and Statistical Manual for Mental Disorders (DSM-III or DSM- III-R) (3,4) have provided operational criteria for classifying depressed subjects in categories. Clus- ter-analytical studies have provided evidence for the descriptive utility of the DSM-III unipolar major depression subtypes (5–8). However, there are various reports that depress- ive classification and depressive phenomenology 29 c Blackwell Munksgaard, Acta Neuropsychiatrica, 14, 1, 29–35 may be influenced by gender and age. Angst and Dobler-Mikola (9) found that women report more depressive symptoms than men. Some authors have argued that the significant differences in sex ratio for major depression, i.e. F/M ratio: ∫ 1.7/1 (10), may be an artefact since women report more symptoms as a criterion for major depression than men (9). Depressive feelings are more severe in women with minor depression, whereas endo- genously depressed men are more severely de- pressed than their female counterparts (11). Severely depressed men exhibit more lack of in- sight, delusions, difficulties at work, social with- drawal and cognitive disturbances than women,