Christensen H, Jorm A F, Mackinnon A J, Korten A E, Jacomb P A, Henderson A S, Rodgers B
NHMRC Psychiatric Epidemiology Research Centre, The Australian National University, Canberra, ACT, Australia.
Psychol Med. 1999 Mar;29(2):325-39. doi: 10.1017/s0033291798008150.
There is debate as to whether the elderly are really at lower risk for depressive disorders, or whether endorsement of symptoms is artefactually low. The present paper assesses the effects of age on anxiety and depression, and examines whether age has direct effects on self-report of individual symptoms independent of its effect on the underlying dimensions of anxiety and depression.
Structural equation modelling was used to assess the structure of the items and their associations with age and a number of demographic variables. The sample of 2622 participants aged between 18 and 79 years from Canberra (Australia) was drawn from the Electoral Roll. Two instruments were used: the anxiety and depression scales of Goldberg et al. (1988) and the Personal Disturbance Scale from the DSSI of Bedford et al. (1976).
Both scales were found to fit satisfactorily to a two factor model. Age correlated negatively with depression. After controlling for the effects of gender, marital status, education and financial difficulty, direct effects of age were found on items from both instruments, indicating that certain depression items were associated with a differential probability of endorsement in older people, even when the level of depression was equal to that of younger people. Items with direct age effects reflected physical (feeling slowed down; waking early) and psychological (hopeless about the future) components of depression. Direct effects of age on items from both anxiety scales were also found.
The nature of the depression and anxiety experienced by younger and older people may differ qualitatively. Depression may be associated with an increase in somatic symptoms linked to physical changes and to an increase in endorsement of items which reflect the narrowing of opportunities in the long-term.
关于老年人患抑郁症的风险是否真的较低,或者症状的认可率是否人为地偏低,存在争议。本文评估年龄对焦虑和抑郁的影响,并研究年龄是否对个体症状的自我报告有直接影响,而不考虑其对焦虑和抑郁潜在维度的影响。
采用结构方程模型评估项目结构及其与年龄和一些人口统计学变量的关联。从堪培拉(澳大利亚)年龄在18至79岁之间的2622名参与者样本是从选民名册中抽取的。使用了两种工具:戈德堡等人(1988年)的焦虑和抑郁量表以及贝德福德等人(1976年)的DSSI中的个人困扰量表。
发现两个量表都能很好地拟合双因素模型。年龄与抑郁呈负相关。在控制了性别、婚姻状况、教育程度和经济困难的影响后,发现年龄对两种工具的项目都有直接影响,这表明即使抑郁水平与年轻人相同,某些抑郁项目在老年人中被认可的概率也有所不同。具有年龄直接影响的项目反映了抑郁的身体(感觉行动迟缓;早醒)和心理(对未来感到绝望)成分。还发现年龄对两种焦虑量表的项目有直接影响。
年轻人和老年人经历的抑郁和焦虑的性质可能在质量上有所不同。抑郁可能与身体变化相关的躯体症状增加以及反映长期机会减少的项目认可率增加有关。