Comorbid anxiety disorders in late-life depression

Area of Science:

• Geriatric Psychiatry
• Clinical Psychology

Background:

• Major depression is prevalent in older adults.
• Comorbid anxiety disorders can complicate depression treatment.
• Understanding anxiety prevalence in elderly depressed patients is crucial.

Purpose of the Study:

• To determine the prevalence and correlates of comorbid anxiety disorders in older patients with major depression.
• To investigate the clinical and therapeutic implications of these comorbidities.

Main Methods:

• A cohort of 336 older outpatients and inpatients with major depression were evaluated.
• Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R) criteria were used.
• Standardized instruments including the Hamilton Depression Rating Scale and either the Schedule for Affective Disorders and Schizophrenia-Lifetime (SADS-L) or the Structured Clinical Interview for DSM-III-R (SCID) were employed.

Main Results:

• One-third to one-half of patients had severe symptomatic anxiety.
• Less than 5% met criteria for panic, obsessive-compulsive, or phobic disorders.
• Lifetime anxiety disorders correlated with higher alcoholism rates, symptomatic anxiety, benzodiazepine use, and a 50% longer outpatient response time to depression treatment.

Conclusions:

• The lifetime prevalence of anxiety disorders appears lower in late-life major depression.
• Despite lower prevalence, comorbid anxiety disorders have significant clinical and therapeutic implications for older depressed patients.
• Early identification and management of anxiety in this population are essential for improved outcomes.