Wuthrich Viviana M, Johnco Carly J, Wetherell Julie L
Department of Psychology,Centre for Emotional Health,Macquarie University,Sydney,Australia.
Department of Psychiatry,University of California,San Diego,La Jolla,CA,USA;VA San Diego Healthcare System,San Diego,CA,USA.
Int Psychogeriatr. 2015 Sep;27(9):1523-32. doi: 10.1017/S1041610215000526. Epub 2015 Apr 20.
Anxiety and depression symptoms change over the lifespan and older adults use different terms to describe their mental health, contributing to under identification of anxiety and depression in older adults. To date, research has not examined these differences in younger and older samples with comorbid anxiety and depression.
One hundred and seven treatment-seeking participants (47 older, 60% female, and 60 younger, 50% female) with anxiety and mood disorders completed the Anxiety Disorders Interview Schedule and a symptom checklist to examine differences in symptom severity, symptom profiles and terms used to describe anxiety and mood.
The findings indicated several key differences between the presentation and description of anxiety and depression in younger and older adults. Older adults with Social Phobia reported fearing a narrower range of social situations and less distress and interference. Older adults with Generalized Anxiety Disorder (GAD) reported less worry about interpersonal relationships and work/school than younger adults, however, there were no differences between age groups for behavioral symptoms endorsed. Further older adults reported phobia of lifts/small spaces more frequently than younger adults. Depressed older depressed adults also reported more anhedonia compared to younger adults, but no differences in terms of reported sadness were found. Finally, older and younger adults differed in their descriptions of symptoms with older adults describing anxiety as feeling stressed and tense, while younger adults described anxiety as feeling anxious, worried or nervous.
Clinicians need to assess symptoms broadly to avoid missing the presence of anxiety and mood disorders especially in older adults.
焦虑和抑郁症状会随着寿命的增长而变化，老年人会用不同的术语来描述他们的心理健康状况，这导致老年人焦虑和抑郁的识别率较低。迄今为止，尚未有研究在合并焦虑和抑郁的年轻和老年样本中检验这些差异。
107名寻求治疗的患有焦虑和情绪障碍的参与者（47名老年人，60%为女性；60名年轻人，50%为女性）完成了焦虑症访谈量表和一份症状清单，以检验症状严重程度、症状特征以及用于描述焦虑和情绪的术语方面的差异。
研究结果表明，年轻人和老年人在焦虑和抑郁症状的表现及描述方面存在几个关键差异。患有社交恐惧症的老年人报告称，他们害怕的社交情境范围更窄，痛苦和干扰更少。患有广泛性焦虑症（GAD）的老年人报告称，与年轻人相比，他们对人际关系和工作/学校的担忧较少，然而，在认可的行为症状方面，不同年龄组之间没有差异。此外，老年人报告电梯/小空间恐惧症的频率高于年轻人。与年轻人相比，老年抑郁症患者也报告了更多的快感缺失，但在报告的悲伤情绪方面没有发现差异。最后，年轻人和老年人在症状描述上存在差异，老年人将焦虑描述为感到压力和紧张，而年轻人将焦虑描述为感到焦虑、担忧或紧张。
临床医生需要广泛评估症状，以避免遗漏焦虑和情绪障碍的存在，尤其是在老年人中。
