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

Abstract

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.