Department of Psychiatry, University of Toronto, Ontario, Canada.
Am J Geriatr Psychiatry. 2010 May;18(5):404-12. doi: 10.1097/jgp.0b013e3181c294ac.
To compare the frequency of anxiety disorders in older and younger persons with major depressive disorder with psychotic features.
Cross-sectional.
University medical centers.
Two hundred fifty-nine persons (N = 117 aged 18-59 years and N = 142 aged > or =60 years) with major depressive disorder with psychotic features who were enrolled in the Study of the Pharmacotherapy of Psychotic Depression (STOP-PD).
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) defined anxiety disorders were determined by Structured Clinical Interview for DSM-IV interview at baseline assessment. Younger and older participants were compared on the frequencies of any current anxiety disorder and any lifetime anxiety disorder, as well as the frequencies of individual anxiety disorders.
Older persons had significantly lower frequencies of any current anxiety disorder and any lifetime anxiety disorder, even after controlling for relevant demographic and clinical variables. With respect to specific anxiety disorders, older persons had significantly lower frequencies of current and lifetime panic disorder, current and lifetime social anxiety disorder, and current and lifetime posttraumatic stress disorder.
The findings of this study are consistent with those of community-based epidemiologic surveys that anxiety disorders are less prevalent in older than younger adults. Because of the rigorous assessment used in STOP-PD, our findings suggest that the age-related decline in the prevalence of anxiety disorders is not simply due to a failure to detect cases in older people, as has been previously suggested.
比较伴精神病性特征的重性抑郁障碍中青年和老年患者焦虑障碍的发生率。
横断面研究。
大学医疗中心。
共 259 例(N = 117 例年龄 18-59 岁,N = 142 例年龄≥60 岁)伴精神病性特征的重性抑郁障碍患者,入组《精神病性抑郁的药物治疗研究》(STOP-PD)。
采用 DSM-IV 定式临床访谈在基线评估时确定 DSM-IV 定义的焦虑障碍。比较了年轻和老年患者当前任何焦虑障碍和终生任何焦虑障碍的发生率,以及各型焦虑障碍的发生率。
即使在控制了相关的人口统计学和临床变量后,老年患者当前任何焦虑障碍和终生任何焦虑障碍的发生率仍显著较低。在特定的焦虑障碍方面,老年患者当前和终生惊恐障碍、当前和终生社交焦虑障碍、当前和终生创伤后应激障碍的发生率显著较低。
本研究结果与基于社区的流行病学调查结果一致,即焦虑障碍在老年人中比在年轻人中更为少见。由于 STOP-PD 中采用了严格的评估方法,我们的研究结果提示,焦虑障碍随年龄增长而减少的现象并非如先前所述,仅仅是因为未能在老年人中检出病例。