TY - JOUR
T1 - Subsyndromal depression and anxiety in older adults
T2 - Health related, functional, cognitive and diagnostic implications
AU - Kasckow, J. W.
AU - Karp, J. F.
AU - Whyte, E.
AU - Butters, M.
AU - Brown, C.
AU - Begley, A.
AU - Bensasi, S.
AU - Reynolds, C. F.
N1 - Funding Information:
Supported in part by P30 MH090333, P60 MD000207, and the UPMC Endowment in Geriatric Psychiatry (CFR). Also supported by AG 033575 (JFK). The contents do not reflect the views of the Department of Veterans Affairs of the US government. Thanks are extended to Elizabeth Skidmore, PhD for her help with this manuscript.
Funding Information:
Dr. Reynolds has received pharmaceutical supplies from Forest Laboratories, Pfizer, Lilly, and BMS for his NIH sponsored research. Dr. Kasckow has served as a consultant for Bristol Meyers Squibb and Forest and has also received grant support from Astra Zeneca. Dr. Karp is a stock owner of Corcept. In addition, he has received medication supplies for an Investigator Initiated Trial from Pfizer, Eli Lilly, and Reckitt Benckiser.
PY - 2013/5
Y1 - 2013/5
N2 - Subsyndromal depression in later life is common in primary care. Comorbid anxiety disorders could exacerbate the negative effect of subsyndromal depression on functioning, health-related quality of life, comorbidity and/or cognition. We examined anxiety disorders co-existing with subsyndromal depression in participants ≥ age 50 in an NIH trial of Problem Solving Therapy for Primary Care for indicated prevention of major depression. There were 247 participants, with Centers for Epidemiologic Studies - Depression scores ≥11. Participants could have multiple psychiatric diagnoses: 22% of the sample had no DSM IV diagnosis; 39% of the sample had only 1 DSM IV diagnosis; 28% had 2 diagnoses; 6% had 3 DSM IV diagnoses; 4% had 4 DSM IV diagnoses; and 1% had 5 diagnoses. Furthermore, 34% of participants had a current comorbid DSM IV diagnosis of a syndromal anxiety disorder. We hypothesized that those with subsyndromal depression, alone relative to those with co-existing anxiety disorders, would report better health-related quality of life, less disability, less medical comorbidity and less cognitive impairment. However, there were no differences in quality of life based on the SF 12 nor in disability based on Late Life Function and Disability Instrument scores. There were no differences in medical comorbidity based on the Cumulative Illness Scale-Geriatrics scale scores nor in cognitive function based on the Executive Interview (EXIT), Hopkins Verbal Learning Test-Revised and Mini-Mental Status Exam. Our findings suggest that about one third of participants 50 years and older with subsyndromal depression have comorbid anxiety disorders; however, this does not appear to be associated with worse quality of life, functioning, disability, cognitive function or medical comorbidity.
AB - Subsyndromal depression in later life is common in primary care. Comorbid anxiety disorders could exacerbate the negative effect of subsyndromal depression on functioning, health-related quality of life, comorbidity and/or cognition. We examined anxiety disorders co-existing with subsyndromal depression in participants ≥ age 50 in an NIH trial of Problem Solving Therapy for Primary Care for indicated prevention of major depression. There were 247 participants, with Centers for Epidemiologic Studies - Depression scores ≥11. Participants could have multiple psychiatric diagnoses: 22% of the sample had no DSM IV diagnosis; 39% of the sample had only 1 DSM IV diagnosis; 28% had 2 diagnoses; 6% had 3 DSM IV diagnoses; 4% had 4 DSM IV diagnoses; and 1% had 5 diagnoses. Furthermore, 34% of participants had a current comorbid DSM IV diagnosis of a syndromal anxiety disorder. We hypothesized that those with subsyndromal depression, alone relative to those with co-existing anxiety disorders, would report better health-related quality of life, less disability, less medical comorbidity and less cognitive impairment. However, there were no differences in quality of life based on the SF 12 nor in disability based on Late Life Function and Disability Instrument scores. There were no differences in medical comorbidity based on the Cumulative Illness Scale-Geriatrics scale scores nor in cognitive function based on the Executive Interview (EXIT), Hopkins Verbal Learning Test-Revised and Mini-Mental Status Exam. Our findings suggest that about one third of participants 50 years and older with subsyndromal depression have comorbid anxiety disorders; however, this does not appear to be associated with worse quality of life, functioning, disability, cognitive function or medical comorbidity.
KW - Anxiety
KW - Cognition
KW - Comorbidity
KW - Functioning
KW - Prevention
KW - Subsyndromal depression
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U2 - 10.1016/j.jpsychires.2013.01.017
DO - 10.1016/j.jpsychires.2013.01.017
M3 - Article
C2 - 23414701
AN - SCOPUS:84875232531
SN - 0022-3956
VL - 47
SP - 599
EP - 603
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
IS - 5
ER -