International Psychogeriatrics

Research Article

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

Osvaldo P. Almeidaa1a2a3 c1, Brian Drapera4, Jane Pirkisa5, John Snowdona6, Nicola T. Lautenschlagera1a2a7, Gerard Byrnea8, Moira Sima9, Nigel Stocksa10, Ngaire Kersea11, Leon Flickera2a12a13 and Jon J. Pfaffa1a2

a1 School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia

a2 Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia

a3 Department of Psychiatry, Royal Perth Hospital, Perth, WA, Australia

a4 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia

a5 School of Population Health, University of Melbourne, Melbourne, VIC, Australia

a6 Discipline of Psychiatry, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia

a7 Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia

a8 School of Medicine, University of Queensland, Brisbane, QLD, Australia

a9 School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia

a10 Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia

a11 School of Population Health, University of Auckland, Auckland, New Zealand

a12 School of Medicine and Pharmacology, University of Western Australia, Crawley, Perth, WA, Australia

a13 Department of Geriatric Medicine, Royal Perth Hospital, Perth, WA, Australia

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.

(Received March 22 2012)

(Revised May 07 2012)

(Revised May 14 2012)

(Accepted May 14 2012)

(Online publication June 12 2012)

Correspondence:

c1 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: osvaldo.almeida@uwa.edu.au.

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