Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-06T05:23:27.808Z Has data issue: false hasContentIssue false
  • English
  • Français

Differences in anxiety and depression symptoms: comparison between older and younger clinical samples

Published online by Cambridge University Press:  20 April 2015

Viviana M. Wuthrich Open the ORCID record for Viviana M. Wuthrich [Opens in a new window] ,
Carly J. Johnco  and
Julie L. Wetherell
Viviana M. Wuthrich*
Affiliation:
Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
Carly J. Johnco
Affiliation:
Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
Julie L. Wetherell
Affiliation:
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
*
Correspondence should be addressed to: Viviana Wuthrich, Centre for Emotional Health, Macquarie University, Sydney, Australia. Phone: +61 2 98504866; Fax: +61 2 9850 8062. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Anxiety and depression symptoms change over the lifespan and older adults use different terms to describe their mental health, contributing to under identification of anxiety and depression in older adults. To date, research has not examined these differences in younger and older samples with comorbid anxiety and depression.

Methods:

One hundred and seven treatment-seeking participants (47 older, 60% female, and 60 younger, 50% female) with anxiety and mood disorders completed the Anxiety Disorders Interview Schedule and a symptom checklist to examine differences in symptom severity, symptom profiles and terms used to describe anxiety and mood.

Results:

The findings indicated several key differences between the presentation and description of anxiety and depression in younger and older adults. Older adults with Social Phobia reported fearing a narrower range of social situations and less distress and interference. Older adults with Generalized Anxiety Disorder (GAD) reported less worry about interpersonal relationships and work/school than younger adults, however, there were no differences between age groups for behavioral symptoms endorsed. Further older adults reported phobia of lifts/small spaces more frequently than younger adults. Depressed older depressed adults also reported more anhedonia compared to younger adults, but no differences in terms of reported sadness were found. Finally, older and younger adults differed in their descriptions of symptoms with older adults describing anxiety as feeling stressed and tense, while younger adults described anxiety as feeling anxious, worried or nervous.

Conclusions:

Clinicians need to assess symptoms broadly to avoid missing the presence of anxiety and mood disorders especially in older adults.

Keywords

anxietydepressiongeriatric psychiatrydiagnosissymptoms
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 9 , September 2015 , pp. 1523 - 1532
Copyright
Copyright © International Psychogeriatric Association 2015 

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

Adams, K. B. (2001). Depressive symptoms, depletion, or developmental change? Withdrawal, apathy and lack of vigor in the Geriatric Depression Scale. The Gerontologist, 41, 768–777.CrossRefGoogle ScholarPubMed
Beekman, A. T., Copeland, J. and Prince, M. (1999). Review of community prevalence of depression in later life. The British Journal of Psychiatry, 174, 307–311.Google Scholar
Beekman, A. T. F., de Beurs, E., van Balkom, A., Deeg, D. J. H., van Dyck, R. and Van Tilburg, W. (2000). Anxiety and depression in later life: co-occurence and communality of risk factors. American Journal of Psychiatry, 157, 89–95.Google Scholar
Bryant, C. (2010). Anxiety and depression in old age: challenges in recognition and diagnosis. International Psychogeriatrics, 22, 511–513.Google Scholar
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurance of mood and anxiety disorders among older adults: the National Comorbidity Survey Replication. JAMA Psychiatry, 67, 489–496.Google Scholar
Carstensen, L. L. and Mikels, J. A. (2005). At the intersection of emotion and cognition: aging and the positivity effect. Current Directions in Psychological Science, 14, 117–121.CrossRefGoogle Scholar
Christensen, H. et al. (1999). Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample. Psychological Medicine, 29, 325–339.Google Scholar
Ciliberti, C., Gould, C., Smith, M., Chorney, D. and Edelstein, B. (2011). A preliminary investigation of developmentally sensitive items for the assessment of social anxiety in late life. Journal of Anxiety Disorders, 25, 686–689.CrossRefGoogle ScholarPubMed
DeNardo, P. A., Brown, T. A. and Barlow, D. H. (1994). Anxiety Disorders Interview Schedule for DSM-IV, Center for Stress and Anxiety Related Disorders, Boston University, Boston.Google Scholar
Fiske, A., Wetherell, J. L. and Gatz, M. (2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363–389.Google Scholar
Flint, A. J. (1994). Epidemiology and comorbidity of anxiety disorders in the elderly. The American Journal of Psychiatry, 151, 640–649.Google Scholar
Gallo, J. J., Anthony, J. C. and Muthen, B. O. (1994). Age differences in the symptoms of depression: a latent trait analysis. Journal of Gerontology, 49, P251–P264.Google Scholar
Goncalves, D. C. and Byrne, G. J. (2013). Who worries most? Worry prevalence and patterns across the lifespan. International Journal of Geriatric Psychiatry, 28, 41–49.CrossRefGoogle ScholarPubMed
Grenier, S. et al. (2011). The epidemiology of specific phobia and subthreshold fear subtypes in a community-based sample of older adults. Depression and Anxiety, 28, 456–463.Google Scholar
Gretarsdottir, E., Woodruff-Borden, J., Meeks, S. and Depp, C. A. (2004). Social anxiety in older adults: Phenomenology, prevalence, and measurement. Behaviour Research and Therapy, 42, 459–475.Google Scholar
Gross, J. J. (2008). Emotion regulation. In Lewis, M., Haviland-Jones, M.. and Barrett, L. F. (eds.), Handbook of Emotions. New York: The Guilford Press.Google Scholar
Gum, A., McDougal, S. J., McIlvane, J. M. and Mingo, C. A. (2010). Older adults are less likely to identify depression without sadness. Journal of Applied Gerontology, 29, 603–621.Google Scholar
Hybels, C. F., Landerman, L. R. and Blazer, D. G. (2012). Age differences in symptom expression in patients with major depression. International Journal of Geriatric Psychiatry, 27, 601–611.Google Scholar
Karlsson, B. et al. (2009). Prevalence of social phobia in non-demented elderly from a Swedish population study. American Journal of Geriatric Psychiatry, 17, 127–135.CrossRefGoogle ScholarPubMed
Kessler, R. C., Chiu, W. T., Demler, O. and Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 617–627.Google Scholar
Letamendi, A. M. et al. (2013). Illness conceptualizations among older rural Mexican–Americans with anxiety and depression. Journal of Cross-Cultural Gerontology, 28, 421–433.Google Scholar
Mezuk, B. and Kendler, K. (2012). Examining variation in depressive symptoms over the life course: a latent class analysis. Psychological Medicine, 42, 2037–2046.Google Scholar
Mioshi, E., Dawson, K., Mitchell, J., Arnold, R. and Hodges, J. R. (2006). The Addenbrooke's Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. International Journal of Geriatric Psychiatry, 21, 1078–1085.Google Scholar
Mohlman, J. et al. (2012). Improving recognition of late life anxiety disorders in diagnostic and statistical manual of mental disorders, fifth edition: observations and recommendations of the advisory committee to the lifespan disorders work group. International Journal of Geriatric Psychiatry, 27, 549–556.Google Scholar
Montario, I., Nuevo, R., Marquez, M., Izal, M. and Losada, A. (2003). Characterization of worry according to severity of anxiety in elderly living in the community. Aging and Mental Health, 7, 334–341.Google Scholar
O’Conner, D. W. and Parslow, R. A. (2009). Different responses to K-10 and CIDI suggest that complex structured psychiatric interviews underestimate rates of mental disorder in old people. Psychological Medicine, 39, 1527–1531.Google Scholar
Shah, R., McNiece, R. and Majeed, A. (2001). General practice consultation rates for psychiatric disorders in patients aged 65 and over: prospective cohort study. International Journal of Geriatric Psychiatry, 16, 57–63.Google Scholar
Trollor, J. N., Anderson, T. M., Sachdev, P. S., Brodaty, H. and Andrews, G. (2007). Prevalence of mental disorders in the elderly: the Australian National Mental Health and Well-being Survey. The American Journal of Geriatric Psychiatry, 15, 455–466.Google Scholar
Wetherell, J. L. et al. (2009). Older adults are less accurate than younger adults at identifying symptoms of anxiety and depression. Journal of Nervous and Mental Disease, 197, 623–626.Google Scholar
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A. and Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27, 190–211.Google Scholar