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Comorbid anxiety disorders in late-life depression: results of a cohort study

Published online by Cambridge University Press:  05 November 2014

D.C. van der Veen ,
W.H. van Zelst ,
R.A. Schoevers ,
H.C. Comijs  and
R.C. Oude Voshaar
D.C. van der Veen*
Affiliation:
University of Groningen, University Medical Center Groningen, Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology, Groningen, the Netherlands
W.H. van Zelst
Affiliation:
University of Groningen, University Medical Center Groningen, Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology, Groningen, the Netherlands
R.A. Schoevers
Affiliation:
University of Groningen, University Medical Center Groningen, Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology, Groningen, the Netherlands
H.C. Comijs
Affiliation:
Department for Psychiatry, EMGO Institute for Health and Care Research / Institute for Neurosciences, VU University, Amsterdam, the Netherlands GGZ inGeest, Amsterdam, the Netherlands
R.C. Oude Voshaar
Affiliation:
University of Groningen, University Medical Center Groningen, Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology, Groningen, the Netherlands
*
Correspondence should be addressed to: Date C. van der Veen, University of Groningen, University Medical Center Groningen, Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology, Groningen, Post office box 30.001 9700 RB, Groningen, the Netherlands. Phone: +31-50-3614124. Email: [email protected].
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Abstract

Background:

Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking previously examined determinants into account.

Methods:

Using the Composite International Diagnostic Interview (CIDI 2.0), we established comorbid anxiety disorders (social phobia (SP), panic disorder (PD), generalized anxiety disorder (GAD), and agoraphobia (AGO)) in 350 patients (aged ≥60 years) suffering from a major depressive disorder according to DSM-IV-TR criteria within the past six months. Adjusted for age, sex, and level of education, we first examined previously identified determinants of anxious depression: depression severity, suicidality, partner status, loneliness, chronic diseases, and gait speed in multiple logistic regression models. Subsequently, associations were explored with the big five personality characteristics as well as early and recent life-events. First, multiple logistic regression analyses were conducted with the presence of any anxiety disorder (yes/no) as dependent variable, where after analyses were repeated for each anxiety disorder, separately.

Results:

In our sample, the prevalence rate of comorbid anxiety disorders in late-life depression was 38.6%. Determinants of comorbid anxiety disorders were a lower age, female sex, less education, higher depression severity, early traumatization, neuroticism, extraversion, and conscientiousness. Nonetheless, determinants differed across the specific anxiety disorders and lumping all anxiety disorder together masked some determinants (education, personality).

Conclusions:

Our findings stress the need to examine determinants of comorbid anxiety disorder for specific anxiety disorders separately, enabling the development of targeted interventions within subgroups of depressed patients.

Keywords

mixed anxiety depressionanxious depressionlate-life depressionanxiety disorderscomorbiditydeterminants
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 7: Late Life Anxiety , July 2015 , pp. 1157 - 1165
Copyright
Copyright © International Psychogeriatric Association 2014 

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