Article2000

Comorbid Anxiety Disorders in Depressed Elderly Patients

Eric J. Lenze · Benoit H. Mulsant · M. Katherine Shear · Herbert C. Schulberg · Mary Amanda Dew · Amy E. Begley +2 more

330 citations0/0 files storedAmerican Journal of Psychiatry

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Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Child and Adolescent Psychosocial and Emotional Development Mental Health Treatment and Access

Abstract

OBJECTIVE: Anxiety disorders are common in adults with depressive disorders, but several studies have suggested a relatively low prevalence of anxiety disorders in older individuals with depression. This cross-sectional study measured current and lifetime rates and associated clinical features of anxiety disorders in depressed elderly patients. METHOD: History of anxiety disorders was assessed by using a structured diagnostic instrument in 182 depressed subjects aged 60 and older seen in primary care and psychiatric settings. Associations between comorbid anxiety disorders and baseline characteristics were measured. The modified structured instrument allowed detection of symptoms that met inclusion criteria for generalized anxiety disorder in a depressive episode. RESULTS: Thirty-five percent of older subjects with depressive disorders had at least one lifetime anxiety disorder diagnosis, and 23% had a current diagnosis. The most common current comorbid anxiety disorders were panic disorder (9.3%), specific phobias (8.8%), and social phobia (6.6%). Symptoms that met inclusion criteria for generalized anxiety disorder, measured separately, were present in 27.5% of depressed subjects. Presence of a comorbid anxiety disorder was associated with poorer social function and a higher level of somatic symptoms. Symptoms of generalized anxiety disorder were associated with a higher level of suicidality. CONCLUSIONS: Contrary to previous reports, the present study found a relatively high rate of current and lifetime anxiety disorders in elderly depressed individuals. Comorbid anxiety disorders and symptoms of generalized anxiety disorder were associated with a more severe presentation of depressive illness in elderly subjects.

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References

1977The CES-D Scale 1967Development of a Rating Scale for Primary Depressive Illness 1976The Global Assessment Scale 1996Comorbidity of DSM–III–R Major Depressive Disorder in the General Population: Results from the US National Comorbidity Survey 1992Major Depression and Generalized Anxiety Disorder 1996Comorbid depression and anxiety spectrum disorders 1996Depression Comorbid with Anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care 1994Epidemiology and comorbidity of anxiety disorders in the elderly

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2013The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?2009Stepped-Care Prevention of Anxiety and Depression in Late Life 2007Evidence-based psychological treatments for late-life anxiety.2010Development and initial validation of a self-report assessment tool for anxiety among older adults: The Geriatric Anxiety Scale 2002Suicidal and Death Ideation in Older Primary Care Patients With Depression, Anxiety, and At-Risk Alcohol Use

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