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BACKGROUND: This report assesses the association between age of onset of major depression and later suicidality in a sample of 276 recurrently depressed patients recruited for the Oxford/Bangor Staying Well after Depression (SWAD) Trial, and interviewed when in remission. METHODS: The study enrolled adult patients with a history of at least three episodes of non-psychotic major depressive disorder from primary care and psychiatric care practices and through community advertisements. At study entry, all participants estimated the age of their first onset of a major depressive episode and completed both self-report and interview-based assessments of past and current suicidal ideation and behavior. Participants were divided into pre-adult and adult onset groups using a cut-off age of 18. RESULTS: Forty-eight percent of the sample reported a pre-adult age of onset. Pre-adult age of onset was significantly associated with suicidality, both from self-report and from interviewer assessment even when adjusting for differences in age, gender, employment status, length of the disorder and early adversity. LIMITATIONS: Relevant variables were all assessed through retrospective reports. CONCLUSIONS: Pre-adult age of onset is closely associated with risk for and severity of later suicidality, replicating, in a sample of patients assessed when in remission, findings from studies that assessed patients when currently depressed. The association of pre-adult age of onset with suicidality is not due to differences in sociodemographic variables, length of the disorder and early adversity.

Original publication




Journal article


J Affect Disord

Publication Date





173 - 179


Adolescent, Adult, Age of Onset, Child, Child, Preschool, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Recurrence, Risk Factors, Suicidal Ideation, Suicide, Suicide, Attempted, Young Adult