Rutgers, tState University of New Jersey, USA.
Int J Geriatr Psychiatry. 2012 Jun;27(6):549-56. doi: 10.1002/gps.2752. Epub 2011 Jul 20.
Recognition of the significance of anxiety disorders in older adults is growing. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a timely opportunity to consider potential improvements to diagnostic criteria for psychiatric disorders for use with older people. The authors of this paper comprise the Advisory Committee to the DSM5 Lifespan Disorders Work Group, the purpose of which was to generate informative responses from individuals with clinical and research expertise in the field of late-life anxiety disorders.
This paper reviews the unique features of anxiety in later life and synthesizes the work of the Advisory Committee.
Suggestions are offered for refining our understanding of the effects of aging on anxiety and other disorders (e.g., mood disorders) and changes to the DSM5 criteria and text that could facilitate more accurate recognition and diagnosis of anxiety disorders in older adults. Several of the recommendations are not limited to the study of anxiety but rather are applicable across the broader field of geriatric mental health.
DSM5 should provide guidelines for the thorough assessment of avoidance, excessiveness, and comorbid conditions (e.g., depression, medical illness, cognitive impairment) in anxious older adults.
人们对老年人焦虑障碍的重要性的认识正在不断提高。《精神障碍诊断与统计手册》（DSM）的修订为考虑潜在的改进精神障碍诊断标准提供了一个及时的机会，以用于老年人。本文的作者是 DSM5 生命期障碍工作组顾问委员会的成员，该委员会的目的是从具有晚年焦虑障碍临床和研究专业知识的个人那里获得有益的回应。
本文回顾了晚年焦虑的独特特征，并综合了顾问委员会的工作。
本文就如何更好地理解衰老对焦虑症和其他障碍（如心境障碍）的影响提出了建议，并对 DSM5 标准和文字进行了修改，以促进更准确地识别和诊断老年焦虑症。其中一些建议不仅限于焦虑症的研究，而是适用于更广泛的老年精神健康领域。
DSM5 应为全面评估焦虑的老年患者的回避、过度和共病情况（如抑郁、疾病、认知障碍）提供指导。
