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Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

Published online by Cambridge University Press:  12 June 2012

Osvaldo P. Almeida ,
Brian Draper ,
Jane Pirkis ,
John Snowdon ,
Nicola T. Lautenschlager ,
Gerard Byrne ,
Moira Sim ,
Nigel Stocks ,
Ngaire Kerse  and
Leon Flicker
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Osvaldo P. Almeida*
Affiliation:
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia Department of Psychiatry, Royal Perth Hospital, Perth, WA, Australia
Brian Draper
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
Jane Pirkis
Affiliation:
School of Population Health, University of Melbourne, Melbourne, VIC, Australia
John Snowdon
Affiliation:
Discipline of Psychiatry, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
Nicola T. Lautenschlager
Affiliation:
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
Gerard Byrne
Affiliation:
School of Medicine, University of Queensland, Brisbane, QLD, Australia
Moira Sim
Affiliation:
School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia
Nigel Stocks
Affiliation:
Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia
Ngaire Kerse
Affiliation:
School of Population Health, University of Auckland, Auckland, New Zealand
Leon Flicker
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia School of Medicine and Pharmacology, University of Western Australia, Crawley, Perth, WA, Australia Department of Geriatric Medicine, Royal Perth Hospital, Perth, WA, Australia
Jon J. Pfaff
Affiliation:
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia
*
Correspondence should be addressed to: Professor Osvaldo P. Almeida, Western Australian Centre for Health & Ageing (M573), Centre for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. Phone: +61 8 9224 2855; Fax: +61 8 9224 8009. Email: [email protected].
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Abstract

Background: This study aimed to determine: (1) the prevalence of depression, anxiety, and depression associated with anxiety (DA); (2) the risk factor profile of depression, anxiety, and DA; (3) the course of depression, anxiety, and DA over 24 months.

Methods: Two-year longitudinal study of 20,036 adults aged 60+ years. We used the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale anxiety subscale to establish the presence of depression and anxiety, and standard procedures to collect demographic, lifestyle, psychosocial, and clinical data.

Results: The prevalence of anxiety, depression, and DA was 4.7%, 1.4%, and 1.8%. About 57% of depression cases showed evidence of comorbid anxiety, while only 28% of those with clinically significant anxiety had concurrent depression. There was not only an overlap in the distribution of risk factors in these diagnostic groups but also differences. We found that 31%, 23%, and 35% of older adults with anxiety, depression, and DA showed persistence of symptoms after two years. Repeated anxiety was more common in women and repeated depression in men. Socioeconomic stressors were common in repeated DA.

Conclusions: Clinically significant anxiety and depression are distinct conditions that frequently coexist in later life; when they appear together, older adults endure a more chronic course of illness.

Keywords

mood disorderanxiety disordermixed stateelderlyprognosisepidemiology
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 10 , October 2012 , pp. 1622 - 1632
Copyright
Copyright © International Psychogeriatric Association 2012

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