Skip to main content Accessibility help
×
Home

Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity

  • K. M. Scott (a1), M. Von Korff (a2), J. Alonso (a3), M. Angermeyer (a4), E. J. Bromet (a5), R. Bruffaerts (a6), G. de Girolamo (a7), R. de Graaf (a8), A. Fernandez (a9), O. Gureje (a10), Y. He (a11), R. C. Kessler (a12), V. Kovess (a13), D. Levinson (a14), M. E. Medina-Mora (a15), Z. Mneimneh (a16), M. A. Oakley Browne (a17), J. Posada-Villa (a18), H. Tachimori (a19) and D. Williams (a20)...

Abstract

Background

Physical morbidity is a potent risk factor for depression onset and clearly increases with age, yet prior research has often found depressive disorders to decrease with age. This study tests the possibility that the relationship between age and mental disorders differs as a function of physical co-morbidity.

Method

Eighteen general population surveys were carried out among household-residing adults as part of the World Mental Health (WMH) surveys initiative (n=42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). The effect of age was estimated for 12-month depressive and/or anxiety disorders with and without physical or pain co-morbidity, and for physical and/or pain conditions without mental co-morbidity.

Results

Depressive and anxiety disorders decreased with age, a result that cannot be explained by organic exclusion criteria. No significant difference was found in the relationship between mental disorders and age as a function of physical/pain co-morbidity. The majority of older persons have chronic physical or pain conditions without co-morbid mental disorders; by contrast, the majority of those with mental disorders have physical/pain co-morbidity, particularly among the older age groups.

Conclusions

CIDI-diagnosed depressive and anxiety disorders in the general population decrease with age, despite greatly increasing physical morbidity with age. Physical morbidity among persons with mental disorder is the norm, particularly in older populations. Health professionals, including mental health professionals, need to address barriers to the management of physical co-morbidity among those with mental disorders.

Copyright

Corresponding author

*Address for correspondence: K. M Scott, Ph.D., Department of Psychological Medicine, Otago University, Wellington, PO Box 7343, Wellington South, New Zealand. (Email: kate.scott@otago.ac.nz)

References

Hide All
Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lepine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Almansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, MA, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martinez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacin, C, Romera, B, Taub, N, Vollebergh, WA (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica Supplementum 420, 2127.
APA (1994). DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Beekman, ATF, Copeland, JRM, Prince, MJ (1999). Review of community prevalence of depression in later life. British Journal of Psychiatry 174, 307311.
Beekman, ATF, Deeg, DJH, Van Tilburg, T, Smit, JH, Hooijer, C, Van Tilburg, W (1995). Major and minor depression in later life: a study of prevalence and risk factors. Journal of Affective Disorders 36, 6575.
Blazer, DG, Hybels, CF (2005). Origins of depression in later life. Psychological Medicine 35, 12411252.
Brilman, E, Ormel, J (2001). Life events, difficulties and onset of depressive episodes in later life. Psychological Medicine 31, 859869.
Brown, S, Inskip, H, Barraclough, B (2000). Causes of the excess mortality of schizophrenia. British Journal of Psychiatry 177, 212217.
Buist-Bouwman, MA, de Graaf, R, Vollebergh, WAM, Ormel, J (2005). Comorbidity of physical and mental disorders and the effect on work-loss days. Acta Psychiatrica Scandinavica 111, 436443.
Christensen, H, Jorm, AF, Mackinnon, AJ, Korten, AE, Jacomb, PA, Henderson, AS, Rodgers, B (1999). Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample. Psychological Medicine 29, 325339.
Coyne, JC, Thompson, R, Klinkman, MS, Nease, JR (2002). Emotional disorders in primary care. Journal of Consulting and Clinical Psychology 70, 798809.
de Graaf, R, Bijl, RV, Ravelli, A, Smit, F, Vollebergh, WAM (2002). Predictors of first incidence of DSM-III-R psychiatric disorders in the general population: findings from the Netherlands Mental Health Survey and Incidence Study. Acta Psychiatrica Scandinavica 106, 303313.
Dew, MA (1998). Psychiatric disorder in the context of physical illness. In Adversity, Stress and Psychopathology (ed. Dohrenwend, B. P.), pp. 177218. Oxford University Press: New York.
Evans, DL, Charney, DS, Lewis, L, Golden, JM, Ranga Rama Krishnan, K, Nemeroff, CB, Bremner, JD, Carney, RM, Coyne, JC, Delong, MR, Frasure-Smith, N, Glassman, AH, Gold, PW, Grant, I, Gwyther, L, Ironson, G, Johnson, RL, Kanner, AM, Katon, WJ, Kaufmann, PG, Keefe, FJ, Ketter, T, Laughren, TP, Leserman, J, Lyketsos, CG, McDonald, WM, McEwan, BS, Miller, AH, Musselman, D, O'Connor, C, Petitto, JM, Pollock, BG, Robinson, RG, Roose, SP, Rowland, J, Sheline, Y, Sheps, DS, Simon, G, Spiegel, D, Stunkard, A, Sunderland, T, Tibbits, P, Valvo, WJ (2005). Mood disorders in the medically ill: scientific review and recommendations. Biological Psychiatry 58, 175189.
Friedli, L, Dardis, C (2002). Not all in the mind: mental health service user perspectives on physical health. Journal of Mental Health Promotion 1, 3646.
Gallo, JJ, Anthony, JC, Muthén, BO (1994). Age differences in the symptoms of depression: a latent trait analysis. Journal of Gerontology 49, 251264.
Harter, MC, Conway, KP, Merikangas, KR (2003). Associations between anxiety disorders and physical illness. European Archives of Psychiatry and Clinical Neuroscience 253, 313320.
Heithoff, K (1995). Does the ECA underestimate the prevalence of late-life depression? Journal of the American Geriatrics Society 43, 26.
Henderson, AS, Jorm, AF, Korten, A, Jacomb, P, Christensen, H, Rodgers, B (1998). Symptoms of depression and anxiety during adult life: evidence of a decline in prevalence with age. Psychological Medicine 28, 13211328.
Hybels, CF, Blazer, D (2002). Epidemiology and geriatric psychiatry. In Textbook in Psychiatric Epidemiology (ed. Tsuang, M. T. and Tohen, M.), pp. 603628. Wiley-Liss Inc.: New York.
Hyland, B, Judd, F, Davidson, S, Jolley, D, Hocking, B (2003). Case managers' attitudes to the physical health of their patients. Australian and New Zealand Journal of Psychiatry 37, 710714.
Jorm, AF (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine 30, 1122.
Karel, MJ (1997). Aging and depression: vulnerability and stress across adulthood. Clinical Psychology Review 17, 847879.
Katon, W, Von Korff, M, Lin, E, Bush, T, Ormel, J (1992). Adequacy and duration of antidepressant treatment in primary care. Medical Care 30, 6776.
Kehoe, R, Wu, S-Y, Leske, MC, Chylack, LT (1994). Comparing self-reported and physician reported medical history. American Journal of Epidemiology 139, 813818.
Kessler, R, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003 a). The epidemiology of major depressive disorder. Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 30953105.
Kessler, R, Foster, C, Webster, PS, House, JS (1992). The relationship between age and depressive symptoms in two national surveys. Psychology and Aging 7, 119126.
Kessler, RC, Bergland, P, Chiu, WT, Demler, O, Heeringa, S, Hiripi, E, Jin, R, Pennell, B-E, Walters, EE, Zaslavsky, A, Zheung, H (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 13, 6992.
Kessler, RC, Ormel, J, Demler, O, Stang, PE (2003 b). Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey. Journal of Occupational and Environmental Medicine 45, 12571266.
Kessler, RC, Ustun, B (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.
Knäuper, B, Wittchen, H-U (1994). Diagnosing major depression in the elderly: evidence for response bias in standardized diagnostic interviews? Journal of Psychiatric Research 28, 147164.
Kriegsman, DM, Penninx, BW, Van Eijk, JT, Boeke, AJ, Deeg, DJ (1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. Journal of Clinical Epidemiology 49, 14071417.
Krishnan, KRR (2002). Biological risk factors in late life depression. Biological Psychiatry 52, 185192.
Mulsant, BH, Ganguli, M (1999). Epidemiology and diagnosis of depression in late life. Journal of Clinical Psychiatry 60 (Suppl. 20), 915.
NCHS (1994). Evaluation of National Health Interview Survey diagnostic reporting. Vital and Health Statistics, Series 2 120, 1116.
Newmann, JP (1989). Aging and depression. Psychology and Aging 4, 150165.
O'Connor, DW (2006). Do older Australians truly have low rates of anxiety and depression? A critique of the 1997 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry 40, 623631.
Ormel, J, Koeter, M, van den Brink, W, van de Willige, G (1991). Recognition, management and course of anxiety and depression in general practice. Archives of General Psychiatry 48, 700706.
Pirkola, SP, Isometsä, E, Suvisaari, J, Aro, H, Joukamaa, M, Poikolainen, K, Koskinen, S, Aromaa, A, Lönnqvist, JK (2005). DSM-IV mood, anxiety and alcohol use disorders and their comorbidity in the Finnish general population. Results from the Health 2000 study. Social Psychiatry and Psychiatric Epidemiology 40, 110.
Regier, DA, Boyd, JH, Burke, JDJ, Rae, DS, Myers, JK, Kramer, M, Robins, LN, George, LK, Karno, M, Locke, BZ (1988). One-month prevalence of mental disorders in the United States. Archives of General Psychiatry 45, 977986.
Schoevers, RA, Beekman, ATF, Deeg, DJ, Geerlings, MI, Jonker, C, Van Tilburg, W (2000). Risk factors for depression in later life; results of a prospective community based study (AMSTEL). Journal of Affective Disorders 59, 127137.
Scott, KM, Bruffaerts, R, Tsang, A, Ormel, J, Alonso, J, Angermeyer, MC, Benjet, C, Bromet, E, de Girolamo, G, de Graaf, R, Gasquet, I, Gureye, O, Haro, JM, He, Y, Kessler, RC, Levinson, D, Mneimneh, ZN, Oakley Browne, MA, Posada-Villa, J, Stein, DJ, Takeshima, T, Von Korff, M (2007). Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health surveys. Journal of Affective Disorders 103, 113120.
Scott, KM, Von Korff, M, Alonso, J, Angermeyer, MC, Bromet, E, Fayyad, J, de Girolamo, G, Demyttenaere, K, Gasquet, I, Gureje, O, Haro, JM, He, Y, Kessler, RC, Levinson, D, Medina Mora, ME, Oakley Browne, MA, Ormel, J, Posada-Villa, J, Watanabe, M, Williams, D (in press). Mental–physical comorbidity and its relationship with disability: results from the World Mental Health surveys. Psychological Medicine.
Siegler, IC, Bastian, LA, Steffens, DC, Bosworth, HB, Costa, PT (2002). Behavioural medicine and aging. Journal of Consulting and Clinical Psychology 70, 843851.
Skoog, I (2004). Psychiatric epidemiology of old age: the H70 study – the NAPE lecture 2003. Acta Psychiatrica Scandinavica 109, 418.
Snowdon, J (2001). Is depression more prevalent in old age? Australian and New Zealand Journal of Psychiatry 35, 782787.
Stordal, E, Mykletun, A, Dahl, AA (2003). The association between age and depression in the general population: a multivariate examination. Acta Psychiatrica Scandinavica 107, 132141.
SUDAAN (2002). SUDAAN Inc., Research Triangle Institute, Research Triangle Park: NC.
Troller, JN, Anderson, TM, Sachdev, PS, Brodaty, H, Andrews, G (2007). Age shall not weary them: mental health in the middle-aged and the elderly. Australian and New Zealand Journal of Psychiatry 41, 581589.
van't Veer-Tazelaar, PJ, van Marwijk, HWJ, Jansen, APD, Rijmen, F, Kostense, PJ, van Oppen, P, van Hout, HPJ, Stalman, WAB, Beekman, ATF (2008). Depression in old age (75+), the PIKO study. Journal of Affective Disorders 106, 295299.
Villamil, E, Huppert, FA, Melzer, D (2006). Low prevalence of depression and anxiety is linked to statutory retirement ages rather than personal work exit: a national survey. Psychological Medicine 36, 9991009.
Wells, JE, Oakley Browne, MA, Scott, KM, McGee, MA, Baxter, J, Kokaua, J (2006). Prevalence, interference with life and severity of DSM-IV disorders in Te Rau Hinengaro: The New Zealand Mental Health Survey. Australian and New Zealand Journal of Psychiatry 40, 845854.
Wells, KB, Golding, JM, Burnam, MA (1989). Affective, substance use, and anxiety disorders in persons with arthritis, diabetes, heart disease, high blood pressure, or chronic lung conditions. General Hospital Psychiatry 11, 320327.

Keywords

Related content

Powered by UNSILO

Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity

  • K. M. Scott (a1), M. Von Korff (a2), J. Alonso (a3), M. Angermeyer (a4), E. J. Bromet (a5), R. Bruffaerts (a6), G. de Girolamo (a7), R. de Graaf (a8), A. Fernandez (a9), O. Gureje (a10), Y. He (a11), R. C. Kessler (a12), V. Kovess (a13), D. Levinson (a14), M. E. Medina-Mora (a15), Z. Mneimneh (a16), M. A. Oakley Browne (a17), J. Posada-Villa (a18), H. Tachimori (a19) and D. Williams (a20)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.