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Prevalence of mental disorders in non-demented elderly people in primary care

Published online by Cambridge University Press:  03 February 2015

Luisa Baladón*
Affiliation:
Parc Sanitari Sant Joan de Déu, Spain; Spanish Network of Research on Preventive Activities and Health Promotion in Primary Care, Sant Boi de Llobregat, Barcelona, Spain
Ana Fernández
Affiliation:
Faculty of Health Sciences, University of Sydney, Center for Disability Research and Policy, Brain and Mind Research Institute, Sydney, Australia; Sant Joan de Déu Foundation; Spanish Network of Research on Preventive Activities and Health Promotion in Primary Care, Sant Boi de Llobregat, Barcelona, Spain
Maria Rubio-Valera
Affiliation:
Sant Joan de Déu Foundation; School of Pharmacy, Universidad de Barcelona; Spanish Network of Research on Preventive Activities and Health Promotion in Primary Care, Sant Boi de Llobregat, Barcelona, Spain
Jorge Cuevas-Esteban
Affiliation:
Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Foundation, CIBERSAM, Barcelona, Spain
Diego J. Palao
Affiliation:
Hospital Parc Taulí, Servei de Salut Mental, Sabadell, Barcelona, Spain
Juan A. Bellon
Affiliation:
Centro de Salud El Palo, Unidad de Investigación del Distrito de Atención Primaria de Málaga; Departamento de Medicina Preventiva, Universidad de Málaga, Spain
Antoni Serrano-Blanco
Affiliation:
Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Foundation, Barcelona, Spain; Spanish Network of Research on Preventive Activities and Health Promotion in Primary Care, Sant Boi de Llobregat, Barcelona, Spain
*
Correspondence should be addressed to: Luisa Baladón, Pablo Picasso 12. Sant Boi de Llobregat 08830, Barcelona, Spain. Phone: 0034936406350 ext:12211; Fax: 0034936542136. Email: [email protected].

Abstract

Background:

Mental disorders in the elderly are common, with a 12-month prevalence in the community ranging from 8.54% to 26.4%. Unfortunately, many mental disorders are unrecognized, untreated, and associated with poor health outcomes. The aim of this paper is to describe the prevalence of mental disorders in the elderly primary care (PC) population and its associated factors by age groups.

Methods:

Cross-sectional survey, conducted in 77 PC centers in Catalonia (Spain), 1,192 patients over 65 years old. The prevalence of mental disorders was assessed through face-to-face evaluations using the Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version (SCID-I-RV) and the Mini International Neuropsychiatric Interview (MINI); chronic physical conditions were noted using a checklist; and disability through the Sheehan Disability Scales (SDS).

Results:

Nearly 20% of participants had a mental disorder in the previous 12 months. Anxiety disorders were the most frequent, (10.9%) (95% CI = 8.2–14.4), followed by mood disorders (7.4%) (95% CI = 5.7–9.5). Being female, greater perceived stress and having mental health/emotional problems as the main reason for consultation were associated with the presence of any mental disorder. There were no differences in prevalence across age groups. Somatic comorbidity was not associated with the presence of mental disorders.

Conclusions:

Mental disorders are highly prevalent among the elderly in PC in Spain. Efforts are needed to develop strategies to reduce this prevalence and improve the well-being of the elderly. Based on our results, we thought it might be useful to assess perceived stress regularly in PC, focusing on people who consult for emotional distress, or that have greater perceived stress.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Almeida, O. P. et al. (1997). Psychiatric morbidity among the elderly in a primary care setting–report from a survey in São Paulo, Brazil. International Journal of Geriatric Psychiatry, 12, 728736.3.0.CO;2-C>CrossRefGoogle Scholar
Aragonès, E. et al. (2004). Prevalence and determinants of depressive disorders in primary care practice in Spain. International Journal of Psychiatry in Medicine, 34, 2135.CrossRefGoogle ScholarPubMed
Bruce, M. L. (2002). Psychosocial risk factors for depressive disorders in late life. Biological Psychiatry, 52, 175184.CrossRefGoogle ScholarPubMed
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurrence of mood and anxiety disorders among older adults: the national comorbidity survey replication. Archives of General Psychiatry, 67, 489496.CrossRefGoogle ScholarPubMed
Charles, S. T. and Carstensen, L. L. (2008). Unpleasant situations elicit different emotional responses in younger and older adults. Psychology and Aging, 23, 495504.CrossRefGoogle ScholarPubMed
Diehl, M., Coyle, N. and Labouvie-Vief, G. (1996). Age and sex differences in strategies of coping and defense across the life span. Psychology and Aging, 11, 127139.CrossRefGoogle ScholarPubMed
Evaluation of National Health Interview Survey diagnostic reporting. (1994). Vital and Health Statistics. Series 2, Data Evaluation and Methods Research, No. 120 1116.Google Scholar
Ferrando, L. et al. (1998). MINI International Neuropsychiatric Interview. (Spanish version 5.0.0.) DSM-IV. Instituto IAP.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version. Biometrics Research. Google Scholar
Freeman, E.W., Sammel, M.D., Liu, L., Gracia, C.R., Nelson, D.B. and Hollander, L. (2004). Hormones and menopausal status as predictors of depression in women in transition to menopause. Archives of General Psychiatry, 61, 6270.CrossRefGoogle ScholarPubMed
Golden, J. et al. (2009). Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. International Journal of Geriatric Psychiatry, 24, 694700.CrossRefGoogle ScholarPubMed
Gum, A. M., King-Kallimanis, B. and Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. The American Journal of Geriatric Psychiatry, 17, 769781.CrossRefGoogle ScholarPubMed
Hybels, C. F. and Blazer, D. G. (2003). Epidemiology of late-life mental disorders. Clinics in Geriatric Medicine, 19, 663696, v.CrossRefGoogle ScholarPubMed
Kim, J.-M. et al. (2011). Stressful events, stress perception and treatment outcomes in patients with depressive disorders: the CRESCEND study. Journal of Affective Disorders, 133, 528536.CrossRefGoogle ScholarPubMed
Klap, R., Unroe, K. T. and Unützer, J. (2003). Caring for mental illness in the United States: a focus on older adults. The American Journal of Geriatric Psychiatry, 11, 517524.CrossRefGoogle ScholarPubMed
Klapow, J. (2002). Psychological disorders and distress in older primary care patients: a comparison of older and younger samples. Psychosomatic Medicine, 64, 635643.Google ScholarPubMed
Lobo-Escolar, A. et al. (2008). Somatic and psychiatric comorbidity in the general elderly population: results from the ZARADEMP project. Journal of Psychosomatic Research, 65, 347355.CrossRefGoogle ScholarPubMed
Luciano, J. V. et al. (2010). Factor structure, internal consistency and construct validity of the sheehan disability scale in a Spanish primary care sample. Journal of Evaluation in Clinical Practice, 16, 895901.CrossRefGoogle Scholar
Lyness, J.M., Caine, E.D., King, D.A., Conwell, Y., Duberstein, P.R. and Cox, C. (2002). Depressive disorders and symptoms in older primary care patients: one-year outcomes. The American Journal of Geriatric Psychiatry, 10, 275282.CrossRefGoogle ScholarPubMed
McDougall, F. A., Matthews, F. E., Kvaal, K., Dewey, M. E. and Brayne, C. (2007). Prevalence and symptomatology of depression in older people living in institutions in England and Wales. Age and Ageing, 36, 562568.CrossRefGoogle ScholarPubMed
Menchetti, M., Cevenini, N., De Ronchi, D., Quartesan, R. and Berardi, D. (2006). Depression and frequent attendance in elderly primary care patients. General Hospital Psychiatry, 28, 119124.CrossRefGoogle ScholarPubMed
Mickey, R. M. and Greenland, S. (1989). The impact of confounder selection criteria on effect estimation. American Journal of Epidemiology, 129, 125137.CrossRefGoogle ScholarPubMed
Mitchell, A. J., Rao, S. and Vaze, A. (2010). Do primary care physicians have particular difficulty identifying late-life depression? A meta-analysis stratified by age. Psychotherapy and Psychosomatics, 79, 285294.CrossRefGoogle ScholarPubMed
Moak, Z. B. and Agrawal, A. (2010). The association between perceived interpersonal social support and physical and mental health: results from the national epidemiological survey on alcohol and related conditions. Journal of Public Health, 32, 191201.CrossRefGoogle ScholarPubMed
Olafsdóttir, M., Marcusson, J. and Skoog, I. (2001). Mental disorders among elderly people in primary care: the Linköping study. Acta Psychiatrica Scandinavica, 104, 12–8.CrossRefGoogle ScholarPubMed
Olivera, J. et al. (2008). Prevalence of psychiatric symptoms and mental disorders detected in primary care in an elderly Spanish population. The PSICOTARD Study: preliminary findings. International Journal of Geriatric Psychiatry, 23, 915921.CrossRefGoogle Scholar
Ormel, J. et al. (2007). Mental disorders among persons with heart disease – results from world mental health surveys. General Hospital Psychiatry, 29, 325334.CrossRefGoogle ScholarPubMed
Park, M. and Unützer, J. (2011). Geriatric depression in primary care. The Psychiatric Clinics of North America, 34, 469487, ix–x.CrossRefGoogle ScholarPubMed
Ritchie, K. et al. (2004). Prevalence of DSM-IV psychiatric disorder in the French elderly population. The British Journal of Psychiatry, 184, 147152.CrossRefGoogle ScholarPubMed
Scott, K. et al. (2007). Depression-anxiety relationships with chronic physical conditions: results from the world mental health surveys. Journal of Affective Disorders, 103, 113120.CrossRefGoogle ScholarPubMed
Serrano-Blanco, A. et al. (2010). Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP). Social Psychiatry and Psychiatric Epidemiology, 45, 201210.CrossRefGoogle ScholarPubMed
Weyerer, S. et al. (2008). Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older. Journal of Affective Disorders, 111, 153163.CrossRefGoogle ScholarPubMed
World Health Organization (2008). Integrating mental health into primary care: a global perspective. Available at: http://whqlibdoc.who.int/publications/2008/9789241563680_eng.pdf.Google Scholar
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