Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T08:29:18.541Z Has data issue: false hasContentIssue false
  • English
  • Français

Subthreshold depressive and anxiety disorders in the elderly

Published online by Cambridge University Press:  16 April 2020

R. Heun ,
A. Papassotiropoulos  and
U. Ptok
R. Heun
Affiliation:
Department of Psychiatry, University of Bonn, Venusberg,D-53105Bonn, Germany
A. Papassotiropoulos
Affiliation:
Department of Psychiatry, University of Bonn, Venusberg,D-53105Bonn, Germany
U. Ptok*
Affiliation:
Department of Psychiatry, University of Bonn, Venusberg,D-53105Bonn, Germany
*
*Correspondence and reprints
Get access

Summary

The aims of the present study were to compare the current and lifetime prevalences for major and subthreshold affective disorders in elderly subjects in the general population, to assess the influence of demographic variables on prevalence rates, and to examine co-morbidity between these disorders. Major and subthreshold disorders were diagnosed in 286 subjects (aged ≥ 60 years). Four-point-nine percent of the subjects had a lifetime diagnosis of major depression, 31.8% either minor or recurrent brief depression, 6.6% a major anxiety disorder, and 18.5% a subthreshold anxiety disorder. The risk for current and lifetime subthreshold anxiety was higher in females than in males, the lifetime prevalence for subthreshold anxiety disorders was increased in elderly subjects and subjects with low professional levels. Increased co-morbidity between major and subthreshold depressive and anxiety disorders could not be observed. In the elderly, subthreshold depressive and anxiety disorders are frequent, more so than major affective disorders. The presence of subthreshold anxiety disorders, but not subthreshold depression, is influenced by age, gender, and previous professional level. Further research focusing on detection, evaluation of risk factors and the relevance for the quality of life in the elderly general population is needed.

Keywords

anxiety disorderdepressionsubthreshold anxiety disorderssubthreshold depression
Type
Original Article
Information
European Psychiatry , Volume 15 , Issue 3 , May 2000 , pp. 173 - 182
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, H.SJudd, L.LGillin, J.CLemmi, HSubthreshold depressions: clinical and polysomnographic validation of dysthymic, residual and masked forms J Affect Disord 45 1997 53–63CrossRefGoogle ScholarPubMed
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Third ed, rev Washington, DCAmerican Psychiatric Association 1987Google Scholar
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Fourth ed Washington, DCAmerican Psychiatric Association 1994Google Scholar
Anderson, JHuppert, FRose, GNormality, deviance and minor psychiatric morbidity in the community. A population-based approach to General Health Questionnaire data in the Health and Lifestyle Survey Psychol M 23 1993 475–485CrossRefGoogle ScholarPubMed
Angst, JThe history and concept of recurrent brief depression Eur Arch Psychiatry Clin Neurosci 244 1994 171–173CrossRefGoogle ScholarPubMed
Angst, JDobler-Mikola, AThe Zurich Study. II. The continuum from normal to pathological depressive mood swings Eur Arch Psychiatr Neurol Sci 234 1984 21–29CrossRefGoogle ScholarPubMed
Angst, JDobler-Mikola, AThe Zurich Study – A prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. IV. Recurrent and noncurrent brief depression Eur Arch Psychiatr Neurol Sci 234 1985 408–416CrossRefGoogle Scholar
Angst, JMerikangas, KThe depressive spectrum: diagnostic classification and course J Affect Disord 45 1997 31–40CrossRefGoogle ScholarPubMed
Angst, JMerikangas, K.RPreisig, MSubthreshold syndromes of depression and anxiety in the community J Clin Psychiatry 58 Suppl 8 1997 6–10Google Scholar
Angst, JMerikangas, KScheidegger, PWicki, WRecurrent brief depression: a new subtype of affective disorder J Affect Disord 19 1990 87–98CrossRefGoogle ScholarPubMed
Beekman, A.T.FDeeg, D.J.HVan Tilburg, TSmit, J.HHooijer, CVan Tilburg, WMajor and minor depression in later life: a study of prevalence and risk factors J Affect Disord 36 1995 65–75CrossRefGoogle ScholarPubMed
Blazer, DThe epidemiology of depression in late life J Geriatr Psychiatry 22 1989 35–52Google ScholarPubMed
Blazer, DWilliams, C.DEpidemiology of dysphoria and depression in an elderly population Am J Psychiatry 137 1980 439–444Google Scholar
Coryell, WDo psychotic, minor and intermittent depressive disorders exist on a continuum? J Affect Disord 45 1997 75–83CrossRefGoogle ScholarPubMed
Davidson, J.R.THughes, D.CGeorge, L.KBlazer, D.GThe boundary of social phobia. Exploring the threshold Arch Gen Psychiatry 51 1994 975–983CrossRefGoogle ScholarPubMed
Ernst, CAngst, JDepression in old age. Is there a real decrease in prevalence? A review Eur Arch Psychiatry Clin Neurosci 245 1995 272–287CrossRefGoogle Scholar
Folstein, M.FFolstein, S.EMc Hugh, P.R‘Mini-Mental State'. A practical method for grading the cognitive state of patients for the clinician J Psychiatr Res 12 1975 189–198CrossRefGoogle Scholar
Girling, D.MHuppert, F.ABrayne, CPaykel, E.SGill, CMathewson, DDepressive symptoms in the very elderly – their prevalence and significance Int J Geriatr Psychiatry 10 1995 497–504CrossRefGoogle Scholar
Hachinski, V.CIliff, L.DZilhka, EDu Boulay, G.HMcAllister, V.LMarshall, J et al. Cerebral blood flow in dementia Arch Neurol 32 1975 632–637CrossRefGoogle ScholarPubMed
Henderson, A.SJorm, A.FMackinnon, AChristensen, HScott, L.RKorten, A.E et al. The prevalence of depressive disorders and the distribution of depressive symptoms in later life: a survey using Draft ICD-10 and DSM-III-R Psychol M 23 1993 719–729CrossRefGoogle ScholarPubMed
Heun, RHardt, JMüller, HMaier, WSelection bias during recruitment of elderly subjects from the General Population for Psychiatric Interviews Eur Arch Psychiatry Clin Neurosci 247 1997 87–92CrossRefGoogle ScholarPubMed
Himmelfarb, SMurrell, S.AThe prevalence and correlates of anxiety symptoms in older adults J Psychol 116 1984 159–167CrossRefGoogle ScholarPubMed
Judd, L.LAkiskal, H.SMaser, J.DZeller, P.JEndicott, JCoryell, W et al. A prospective 12-year study of subsyndromal and syndromal depresssive symptoms in unipolar major depressive disorders Arch Gen Psychiatry 55 1998 694–700CrossRefGoogle Scholar
Judd, L.LAkiskal, H.SPaulus, M.PThe role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder J Affect Disord 45 1997 5–18CrossRefGoogle Scholar
Judd, L.LKunovac, J.LBipolar and unipolar depressive disorders in geriatric patientsBrunello, NLanger, SzRacagni, GMental disorders in the elderly: New therapeutic approaches BaselKarger 1998 1–10Google Scholar
Kessler, R.CZhao, SBlazer, D.GSwartz, MPrevalence, correlates, and course of minor depression and major depression in the national co-morbidity survey J Affect Disord 45 1997 19–30CrossRefGoogle Scholar
Kirby, MBruce, IRadic, ACoakley, DLawlor, B.AMental disorders among the community-dwelling elderly in Dublin Br J Psychiatry 171 1997 369–372CrossRefGoogle ScholarPubMed
Koenig, H.GBlazer, D.GEpidemiology of geriatric affective disorders Clin Geriatr M 8 1997 235–251CrossRefGoogle Scholar
Lynch, D.JTamburrino, M.BNagel, RTelephone counseling for patients with minor depression: preliminary findings in a family practice setting J Fam Pract 44 1997 293–298Google Scholar
Maier, WGänsicke, MWeiffenbach, OThe relationship between major and subthreshold variants of unipolar depression J Affect Disord 45 1997 41–51CrossRefGoogle ScholarPubMed
Maier, WHerr, RGänsicke, MLichtermann, DHoushangpour, KBenkert, ORecurrent brief depression in general practice. Clinical features, co-morbidity with other disorders, and need for treatment Eur Arch Psychiatry Clin Neurosci 244 1997 196–204CrossRefGoogle Scholar
Maier, WHerr, RLichtermann, DGänsicke, MBenkert, OFaust, GBrief depression among patients in general practice. Prevalence and variation by recurrence and severity Eur Arch Psychiatry Clin Neurosci 244 1994 190–195CrossRefGoogle ScholarPubMed
Meller, IFichter, M.MSchröppel, HRisk factors and psychosocial consequences in depression of octo- and nonagenerians: results of an epidemiological study Eur Arch Psychiatry Clin Neurosci 247 1994 278–287CrossRefGoogle Scholar
Merikangas, K.RWicki, WAngst, JHeterogeneity of depression. Classification of depressive subtypes by longitudinal course Br J Psychiatry 164 1994 342–348CrossRefGoogle ScholarPubMed
Olfson, MBroadhead, W.EWeissman, M.MLeon, A.CFarber, LHoven, C et al. Subthreshold psychiatric symptoms in a primary care group practice Arch Gen Psychiatry 53 1996 880–886CrossRefGoogle Scholar
Sartorius, NÜstün, BLecrubier, YWittchen, H.UDepression co-morbid with anxiety: Results from the WHO Study on psychological disorders in primary health care Br J Psychiatry 168 Suppl 30 1996 38–43CrossRefGoogle Scholar
SAS Institute SAS/STAT user's guide, version 6, fourth ed Cary, NCSAS Institute 1990Google Scholar
Sherbourne, C.DWells, K.BHays, R.DRogers, WBurnam, M.AJudd, L.LSubthreshold depression and depressive disorder: clinical characteristics of general medical and mental health specialty outpatients Am J Psychiatry 151 1994 1777–1784Google ScholarPubMed
Sheskin, D.JHandbook of parametric and nonparametric statistical procedures Boca ratonCRC Press 1997Google Scholar
Simon, GOrmel, JVonkorff, MBarlow, WHealthcare costs associated with depressive and anxiety disorders in primary care Am J Psychiatry 152 1995 352–357Google ScholarPubMed
Szegedi, AWetzel, HAngersbach, DPhilipp, MBenkert, OResponse to treatment in minor and major depression: results of a double-blind comparative study with paroxetine and maprotiline J Affect Disord 45 1997 167–178CrossRefGoogle ScholarPubMed
Wall, T.DBolden, R.IBorrill, C.SCarter, A.JGolya, D.AHardy, G.E et al. Minor psychiatric disorder in NHS trust staff: occupational and gender differences Br J Psychiatry 171 1997 519–523CrossRefGoogle ScholarPubMed
Weiller, EBoyer, PLépine, J.PLecrubier, YPrevalence of recurrent brief depression in primary care Eur Arch Psychiatry Clin Neurosci 244 1997 174–181CrossRefGoogle Scholar
Weiller, ELecrubier, YMaier, WUstün, T.BThe prevalence of recurrent brief depression in primary care. A report from the WHO Project on Psychological Problems in General Health Care conducted in 14 countries Eur Arch Psychiatry Clin Neurosci 244 1994 182–189CrossRefGoogle ScholarPubMed
Wells, K.BBurnam, M.ARogers, WHays, RCamp, PThe course of depression in adult outpatients. Results from the medical outcomes study Arch Gen Psychiatry 49 1992 788–795CrossRefGoogle ScholarPubMed
Williams, J.WKerber, C.AMurlow, C.DMedina, AAguilar, CDepressive disorders in primary care: prevalence, functional disability, and identification J Gen Intern M 10 1995 7–12CrossRefGoogle ScholarPubMed
World Heath Organization Composite International Diagnostic Interview GenevaWorld Health Organization, Division of Mental Health 1990Google Scholar
World Health Organization The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Describtions and Diagnostic Guidelines GenevaWorld Health Organization 1992Google Scholar
Zaudig, MMittelhammer, JHiller, WPauls, AThora, CMorinigo, A et al. SIDAM – A structured interview for the diagnosis of dementia of the Alzheimer type, multi-infarct dementia and dementias of other aetiology according to ICD-10 and DSM-III-R Psychol M 21 1991 225–226CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.