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

Published online by Cambridge University Press:  19 May 2008

K. M. Scott ,
M. Von Korff ,
J. Alonso ,
M. Angermeyer ,
E. J. Bromet ,
R. Bruffaerts ,
G. de Girolamo ,
R. de Graaf ,
A. Fernandez  and
O. Gureje
...Show all authors
K. M. Scott*
Affiliation:
Department of Psychological Medicine, Otago University, Wellington, New Zealand
M. Von Korff
Affiliation:
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA, USA
J. Alonso
Affiliation:
Health Services Research Unit, Institute Municipal d'Investigacio Medica (IMIM), and CIBER en Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
M. Angermeyer
Affiliation:
Center for Public Mental Health, Austria
E. J. Bromet
Affiliation:
SUNY Stony Brook, Stony Brook, New York, USA
R. Bruffaerts
Affiliation:
Department of Neurosciences and Psychiatry, University Hospital, Gasthuisberg, Leuven, Belgium
G. de Girolamo
Affiliation:
Regional Health Care Agency, Emilia-Romagna Region, Bologna, Italy
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
A. Fernandez
Affiliation:
Fundació Sant Joan de Déu Research and Development Unit, Barcelona, Spain
O. Gureje
Affiliation:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
Y. He
Affiliation:
Shanghai Mental Health Center, Shanghai, People's Republic of China
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
V. Kovess
Affiliation:
Fondation MGEN Pour La Santé Publique, Université Paris 5, Paris, France
D. Levinson
Affiliation:
Mental Health Services, Ministry of Health, Jerusalem, Israel
M. E. Medina-Mora
Affiliation:
Department of Epidemiology, National Institute of Psychiatry, Mexico City, Mexico
Z. Mneimneh
Affiliation:
Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
M. A. Oakley Browne
Affiliation:
Department of Rural and Indigenous Health, School of Rural Health, Monash University, Victoria, Australia
J. Posada-Villa
Affiliation:
Colegio Mayor de Cundinamarca University, Bogota, Colombia
H. Tachimori
Affiliation:
National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
D. Williams
Affiliation:
Department of Society, Human Development and Health, Harvard School of Public Health, Harvard University, Boston, MA, USA
*
*Address for correspondence: K. M Scott, Ph.D., Department of Psychological Medicine, Otago University, Wellington, PO Box 7343, Wellington South, New Zealand. (Email: [email protected])
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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.

Keywords

Ageanxiety disorderco-morbiditydepressive disorderphysical
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 11 , November 2008 , pp. 1659 - 1669
Copyright
Copyright © 2008 Cambridge University Press

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