How does the initial presentation of major depressive disorder (clinical depression) vary in adults, children, and elderly persons?

Updated: Aug 06, 2020
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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Patients with major depressive disorder may not initially present with a complaint of low mood, anhedonia, or other typical symptoms. In the primary care setting, where many of these patients first seek treatment, the presenting complaints often can be somatic (e.g., fatigue, headache, abdominal distress, or change in weight). Patients may complain more of irritability or difficulty concentrating than of sadness or low mood.

Children with major depressive disorder may also present with initially misleading symptoms such as irritability, decline in school performance, or social withdrawal. Elderly persons may present with confusion or a general decline in functioning; they also experience more somatic complaints, cognitive symptoms, and fewer complaints of sad or dysphoric mood.

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