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Chapter 3 - Diagnosis of Anxiety Disorders in Older Adults

Published online by Cambridge University Press:  08 March 2021

By
Christina Bryant
Edited by
Gerard J. Byrne  and
Nancy A. Pachana
Gerard J. Byrne
Affiliation:
University of Queensland
Nancy A. Pachana
Affiliation:
University of Queensland
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Summary

Debates about diagnosis in psychiatry and clinical psychology are both ever-present and controversial. They have recently gained greater prominence in the context of the publication of the fifth edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association (2013). On the one hand, some authors are concerned that diagnostic processes impose unhelpful labels on human experience and lead to an over-reliance on their imperfect categories (Healy, 2011), while others suggest that the importance of diagnosis is growing rather than diminishing (Craddock & Mynors-Wallis, 2014). It is well documented that there are a number of features of anxiety disorders in older adults that pose specific challenges to both recognition and diagnosis (Bryant, 2010). This chapter considers some of the factors that make the diagnosis of anxiety disorders particularly complex in older adults.

Type
Chapter
Information
Anxiety in Older People
Clinical and Research Perspectives
 , pp. 20 - 32
Publisher: Cambridge University Press
Print publication year: 2021

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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association.Google Scholar
Beck, A. T., Epstein, N., Brown, G. and Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897.Google Scholar
Beekman, A. T., Bremmer, M. A., Deeg, D. J., et al. (1998). Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. International Journal of Geriatric Psychiatry, 13(10), 717–726.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Bei, B., Bryant, C., Gilson, K.-M., et al. (2013). A prospective study of the impact of floods on the mental and physical health of older adults. Aging and Mental Health, 17(8), 992–1002.Google Scholar
Bierman, E., Comijs, H., Jonker, C. and Beekman, A. (2007). Symptoms of anxiety and depression in the course of cognitive decline. Dementia and Geriatric Cognitive Disorders, 24(3), 213–219.Google Scholar
Bryant, C. (2010). Anxiety and depression in old age: challenges in recognition and diagnosis. International Psychogeriatrics, 22(4), 511–513.Google Scholar
Bryant, C., Jackson, H. and Ames, D. (2009). Depression and anxiety in medically unwell older adults: prevalence and short-term course. International Psychogeriatrics, 21(4), 754–763.Google Scholar
Bryant, C., Mohlman, J., Gum, A., et al. (2013). Anxiety disorders in older adults: Looking to DSM5 and beyond… American Journal of Geriatric Psychiatry, 21(9), 872–876.CrossRefGoogle ScholarPubMed
Byrne, G. J. and Pachana, N. A. (2011). Development and validation of a short form of the Geriatric Anxiety Inventory – the GAI-SF. International Psychogeriatrics, 23(1), 125–131.Google Scholar
Campbell, G., Bryant, C., Ellis, K. A., Buckley, R. and Ames, D. (2015). Comparing the Performance of the HADS and the GDS-15 in the AIBL study. International Psychogeriatrics, 27(9), 1577–1578.Google Scholar
Copeland, J., Dewey, M. E. and Griffiths-Jones, H. (1986). A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16(1), 89–99.Google Scholar
Copeland, J. R., Dewey, M. E., Wood, N., Searle, R., Davidson, I. and McWilliam, C. (1987). Range of mental illness among the elderly in the community. Prevalence in Liverpool using the GMS-AGECAT package. British Journal of Psychiatry, 150(6), 815–823.Google Scholar
Coyne, J. C. and van Sonderen, E. (2012). No further research needed: abandoning the Hospital and Anxiety Depression Scale (HADS). Journal of Psychosomatic Research, 72(3), 173–174.CrossRefGoogle ScholarPubMed
Craddock, N. and Mynors-Wallis, L. (2014). Psychiatric diagnosis: impersonal, imperfect and important. British Journal of Psychiatry, 204(2), 93–95.Google Scholar
Creamer, M. and Parslow, R. (2008). Trauma exposure and posttraumatic stress disorder in the elderly: a community prevalence study. American Journal of Geriatric Psychiatry, 16(10), 853–856.Google Scholar
Davies, K. N., Burn, W. K., McKenzie, F. R., Brothwell, J. A. and Wattis, J. P. (1993). Evaluation of the hospital anxiety and depression scale as a screening instrument in geriatric medical inpatients. International Journal of Geriatric Psychiatry, 8(2), 165–169.Google Scholar
Eremenco, S. L., Cella, D. and Arnold, B. J. (2005). A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Evaluation & the health professions, 28(2), 212–232.CrossRefGoogle ScholarPubMed
First, M. B. (2002). User’s Guide for the Structured Clinical Interview for DSM-IV-TR Axis I Disorders: SCID-I. New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Flint, A. J. (2005). Generalised anxiety disorder in elderly patients. Drugs and Aging, 22(2), 101–114.CrossRefGoogle ScholarPubMed
Flint, A. J. and Rifat, S. L. (2002). Factor structure of the hospital anxiety and depression scale in older patients with major depression. International Journal of Geriatric Psychiatry, 17(2), 117–123.Google Scholar
Frances, A. J. and Widiger, T. (2012). Psychiatric diagnosis: lessons from the DSM-IV past and cautions for the DSM-5 future. Annual Review of Clinical Psychology, 8, 109–130.Google Scholar
Gagnon, N., Flint, A. J., Naglie, G. and Devins, G. M. (2005). Affective correlates of fear of falling in elderly persons. American Journal of Geriatric Psychiatry, 13(1), 7–14.Google Scholar
Gornall, J. (2013). DSM-5: a fatal diagnosis? BMJ, 346, f3256.Google Scholar
Hamilton, M., Schutte, N. and Malouff, J. (1976). Hamilton anxiety scale (HAMA). In Schutte, N. S. and Malouff, J. M., eds., Sourcebook of Adult Assessment: Applied Clinical Psychology. New York: Plenum Press, pp. 154–157.Google Scholar
Healy, P. (2011). DSM diagnosis and beyond: on the need for a hermeneutically-informed biopsychosocial framework. Medicine, Health Care and Philosophy, 14(2), 163–175.Google Scholar
Jeste, D. V., Blazer, D. G. and First, M. (2005). Aging-related diagnostic variations: need for diagnostic criteria appropriate for elderly psychiatric patients. Biological Psychiatry, 58(4), 265–271.CrossRefGoogle ScholarPubMed
Johnstone, L. and Dallos, R. (2013). Formulation in Psychology and Psychotherapy: Making Sense of People’s Problems. Abingdon: Routledge.Google Scholar
Karel, M. J., Gatz, M. and Smyer, M. A. (2012). Aging and mental health in the decade ahead: what psychologists need to know. American Psychologist, 67(3), 184–198.Google Scholar
Karlsson, B., Klenfeldt, I. F., Sigström, R., et al. (2009). Prevalence of social phobia in non-demented elderly from a Swedish population study. American Journal of Geriatric Psychiatry, 17(2), 127–135.Google Scholar
Knight, B. G. and Pachana, N. A. (2015). Psychological Assessment and Therapy with Older People. Oxford: Oxford University Press.CrossRefGoogle Scholar
Knight, B. G. and Poon, C. (2008). The socio-cultural context in understanding older adults: contextual adult life span theory for adapting psychotherapy. In Woods, B and Clare, L, eds., The Handbook of the Clinical Psychology of Ageing. Hoboken, NJ: John Wiley & Sons, pp. 439–456.Google Scholar
Lachman, M. E., Howland, J., Tennstedt, S., et al. (1998). Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 53(1), P43–P50.Google Scholar
Lenze, E. J., Mulsant, B. H., Mohlman, J., et al. (2005). Generalized anxiety disorder in late life: lifetime course and comorbidity with major depressive disorder. American Journal of Geriatric Psychiatry, 13(1), 77–80.Google Scholar
Lenze, E. J., Mulsant, B. H., Shear, M. K., Alexopoulos, G. S., Frank, E. and Reynolds, C. F. (2001). Comorbidity of depression and anxiety disorders in later life. Depression and Anxiety, 14(2), 86–93.Google Scholar
Lin, X., Bryant, C., Boldero, J. and Dow, B. (2015). Older Chinese immigrants’ relationships with their children: a literature review from a solidarity–conflict perspective. The Gerontologist, 55(6), 990–1005.CrossRefGoogle ScholarPubMed
Lin, X., Haralambous, B., Pachana, N. A., et al. (2016). Screening for depression and anxiety among older Chinese immigrants living in Western countries: the use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI). Asia‐Pacific Psychiatry, 8(1), 32–43.Google Scholar
Mohlman, J., Bryant, C., Lenze, E. J., et al. (2012a). Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group. International Journal of Geriatric Psychiatry, 27(6), 549–556.Google Scholar
Mohlman, J., Sirota, K. G., Papp, L. A., Staples, A. M., King, A. and Gorenstein, E. E. (2012b). Clinical interviewing with older adults. Cognitive and Behavioral Practice, 19(1), 89–100.Google Scholar
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19(1), 103–114.Google Scholar
Parker, G., Gladstone, G. and Chee, K. T. (2001). Depression in the planet’s largest ethnic group: the Chinese. American Journal of Psychiatry, 158(6), 857–864.Google Scholar
Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N. and Stanley, M. (2008). Anxiety in dementia: a critical review. Clinical Psychology Review, 28(7), 1071–1082.Google Scholar
Selwood, A., Thorgrimsen, L. and Orrell, M. (2005). Quality of life in dementia – a one‐year follow‐up study. International Journal of Geriatric Psychiatry, 20(3), 232–237.Google Scholar
Shankar, K. K., Walker, M., Frost, D. and Orrell, M. W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging and Mental Health, 3(1), 39–49.Google Scholar
Shedler, J., Beck, A., Fonagy, P., et al. (2010). Personality disorders in DSM-5. American Journal of Psychiatry, 167(9), 1026–1028.Google Scholar
Sinoff, G., Ore, L., Zlotogorsky, D. and Tamir, A. (1999). Short anxiety screening test – a brief instrument for detecting anxiety in the elderly. International Journal of Geriatric Psychiatry, 14(12), 1062–1071.Google Scholar
Wittchen, H.-U., Robins, L. N., Semler, W. J., Cottler, L. and World Health Organization (1993). Composite International Diagnostic Interview (CIDI): Interviewer’s Manual. Geneva: World Health Organization.Google Scholar
Yesavage, J. A., Brink, T., Rose, T. L., et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17(1), 37–49.Google Scholar
Yohannes, A. M., Baldwin, R. C. and Connolly, M. J. (2000). Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. International Journal of Geriatric Psychiatry, 15(12), 1090–1096.Google Scholar
Zarit, S. H. and Zarit, J. M. (2012). Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment. New York: Guilford Press.Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.Google Scholar

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