School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Department of Psychiatry, Monash University, Clayton, Victoria, Australia.
Department of Psychiatry, Monash University, Clayton, Victoria, Australia; Institute for Health & Ageing, Australian Catholic University, Melbourne, Victoria, Australia.
J Affect Disord. 2018 Feb;227:416-423. doi: 10.1016/j.jad.2017.11.029. Epub 2017 Nov 10.
Little is known about anxiety in aged care populations, despite its increase in this frail population. This study investigated the prevalence, recording, and treatment rate of anxiety disorders among aged care residents.
A cross-sectional, observational design was used to assess 180 elderly residents from 12 aged care facilities in Melbourne, Australia. Participants were assessed for threshold and subthreshold anxiety disorders and comorbid depression using the MINI for DSM-5. Medical files were also reviewed to determine whether there was any indication that anxiety had previously been detected, and what treatment those with a threshold/subthreshold diagnosis were receiving.
Overall prevalence of threshold and subthreshold anxiety disorders was 19.4% and 11.7%, respectively. Generalized anxiety disorder was the most common threshold disorder and agoraphobia was the most prevalent subthreshold anxiety disorder. While less than half of those with a threshold or subthreshold anxiety disorder had an indication of anxiety in their file, the majority received psychotropic medication. Cognitive impairment was not significantly associated with the prevalence or treatment of anxiety.
The prevalence of threshold and subthreshold anxiety in aged care settings is high, but remains under-reported by staff and GPs. Facility staff and GPs should ensure they are aware of how anxiety presents in elderly residents and routinely screen for this common mental health issue. This cohort had poor access to psychological treatments for their condition.
尽管脆弱人群中的焦虑症发病率有所增加,但人们对老年护理人群中的焦虑症知之甚少。本研究调查了老年护理居民中焦虑症的患病率、记录率和治疗率。
采用横断面、观察性设计评估了来自澳大利亚墨尔本 12 家老年护理机构的 180 名老年居民。使用 DSM-5 MINI 评估参与者是否存在阈限和亚阈限焦虑障碍以及共病性抑郁。还审查了医疗档案,以确定是否有任何迹象表明之前曾发现过焦虑症,以及那些有阈限/亚阈限诊断的人正在接受何种治疗。
总体而言,阈限和亚阈限焦虑障碍的患病率分别为 19.4%和 11.7%。广泛性焦虑障碍是最常见的阈限障碍,广场恐怖症是最常见的亚阈限焦虑障碍。尽管只有不到一半的阈限或亚阈限焦虑障碍患者的档案中有焦虑迹象,但大多数患者接受了精神药物治疗。认知障碍与焦虑的患病率或治疗无显著相关性。
老年护理环境中阈限和亚阈限焦虑的患病率较高,但仍未得到工作人员和全科医生的充分报告。设施工作人员和全科医生应确保他们了解焦虑在老年居民中的表现,并定期筛查这一常见的心理健康问题。该队列患者获得其病情的心理治疗的机会较差。