Comorbidity of depressive and anxiety disorders for older Americans in the national comorbidity survey-replication.

OBJECTIVE

To identify age differences in the 12-month and lifetime comorbidity of depressive and anxiety disorders for adults (18-64 years) compared with older adults (65 years and older) in a nationally representative sample of community-dwelling adults in the United States.

DESIGN

Cross-sectional epidemiologic study, using data from the National Comorbidity Survey-Replication public use dataset.

SETTING

Community-based epidemiologic survey.

PARTICIPANTS

Representative national sample of community-dwelling adults in the United States.

MEASUREMENTS

The World Health Organization Composite International Diagnostic Interview was used to assess Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric disorders.

RESULTS

More than half of respondents with a 12-month major depressive disorder (MDD) had a comorbid anxiety disorder or dysthymia (18-64 years = 60.6%; 65 years and older = 51.8%). High rates of MDD were also found for those with anxiety disorders across both age groups, highest in the 18-64 years group for generalized anxiety disorder (28.5%) and highest in the 65 years and older group for panic disorder (36.7%). Age group did not predict 12-month diagnosis of a comorbid anxiety disorder among those with a depressive disorder in multivariate logistic regression. Onset of anxiety disorders preceded onset of depressive disorders for most older adults (77.6%).

CONCLUSIONS

Depressive and anxiety disorders frequently cooccurred in this representative sample of community-dwelling adults. Older adults experienced comorbidity to a similar extent as younger adults, suggesting high rates of comorbidity across the lifespan.