A cross-sectional, multicenter study by the Russian National Consortium for Psychiatric Genetics enrolled 172 patients with depression in order to analyze the clinical features of the course of early-onset depression. Early-onset depression is associated with hypersomnia and decreased libido, as well as higher severity of the current depressive episode. In addition, early-onset depression is associated with the presence of concomitant obsessive-compulsive disorder and, in combination with family history of mood disorders, with a longer duration of the depressive episode. Early onset depression is an important trait representing a genetic influence on the development of depression. Further clinical and genetic studies are needed to investigate the specific effects of age of onset on the clinical manifestations and course of depression. © 2021, V. Serbsky National Medical Research Centre for Psychiatry and Narcology. All rights reserved.