Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication.
ABSTRACT Current information on the prevalence of psychiatric disorders among older adults in the United States is lacking. Prevalence of anxiety, mood, and substance disorders was examined by age (18-44, 45-64, 65-74, and 75 years and older) and sex. Covariates of disorders for older adults (65 years and older) were explored.
Cross-sectional epidemiologic study, using data from the National Comorbidity Survey-Replication.
Community-based epidemiologic survey.
Representative national sample of community-dwelling adults in the United States.
The World Health Organization Composite International Diagnostic Interview was used to assess Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric disorders.
Prevalence of 12-month and lifetime mood, anxiety, and substance-use disorders was lower for older adults (65 years and older) than younger age groups: 2.6% for mood disorder, 7.0% for anxiety disorder, 0 for any substance-use disorder, and 8.5% for any of these disorders (for any disorder, 18-44 years = 27.6%, 45-64 years = 22.4%). Among older adults, presence of a 12-month anxiety disorder was associated with female sex, lower education, being unmarried, and three or more chronic conditions. Presence of a 12-month mood disorder was associated with disability. Similar patterns were noted for lifetime disorders (any disorder: 18-44 years = 46.4%, 45-64 years = 43.7%, and 65 years and older = 20.9%).
This study documents the continued pattern of lower rates of formal diagnoses for elders. These rates likely underestimate the burden of late-life psychiatric disorders, given the potential for underdiagnosis, clinical significance of subthreshold symptoms, and lack of representation from high-risk older adults (e.g., medically ill, long-term care residents).
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ABSTRACT: Despite the prevalence of anxiety in later life, there are no published studies on treatment preferences of older adults for anxiety problems. The current study utilized a survey method to inquire about treatment preferences in three age group cohorts (N = 383; young-, middle-, and oldest-old) recruited from the community, as opposed to primary care. Participants were asked to imagine that they were suffering from anxiety that had become severe enough to interfere with daily activities and were seeking mental health treatment. Each was asked to first indicate their preference for pharmacological, psychological, or combined treatment. Those who chose psychological or combined treatment were then asked to indicate which specific psychotherapeutic intervention they preferred from a list of six possible choices and to indicate their preference for setting and format of treatment. The sample generally preferred psychotherapy to medication or combined treatment for help with anxiety, delivered either in a primary care, specialty mental health, or university setting. Furthermore, specific treatment and format preferences varied by age group. Some of the current results (e.g., preference for psychotherapy over medication) run counter to those obtained from studies of depression treatment preference in samples of similar age (e.g., preference for medication over psychotherapy; Gum et al., 2006). (PsycINFO Database Record (c) 2011 APA, all rights reserved).Psychology and Aging 04/2011; DOI:10.1037/a0023126 · 2.73 Impact Factor
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ABSTRACT: Recent theories have proposed a metastructure that organizes related mental disorders into broad dimensions of psychopathology (i.e., internalizing and externalizing dimensions). Prevalence rates of most mental disorders, when examined independently, are substantially lower in older than in younger adults, which may affect this metastructure. Within a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093), we developed a dimensional liability model of common psychiatric disorders to clarify whether aging affects specific disorders or general dimensions of psychopathology. Significant age differences existed across age groups (18-24, 25-34, 35-44, 45-54, 55-64, 65-75 and 75+), such that older adults showed lower prevalence rates of most disorders compared to younger adults. We next investigated patterns of disorder comorbidity for past-year psychiatric disorders and found that a distress-fear-externalizing liability model fit the data well. This model was age-group invariant and indicated that the observed lower prevalence of mental disorders with advancing age originates from lower average means on externalizing and internalizing liability dimensions. This unifying dimensional liability model of age and mental disorder comorbidity can help inform the role of aging on mental disorder prevalence for research and intervention efforts, and service planning for the impending crisis in geriatric mental health. Copyright © 2015 Elsevier Ltd. All rights reserved.Journal of Psychiatric Research 03/2015; 64. DOI:10.1016/j.jpsychires.2015.03.017 · 4.09 Impact Factor
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ABSTRACT: Aging of population is currently a global phenomenon. At least one in 5 people over the age of 65 years will suffer from a mental disorder by 2030. Study of psychiatric morbidities in this age group is essential to prepare for upcoming challenges. To find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. Retrospective review; Psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal. Data for patients ≥ 65 years of age attending the psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal, from 1(st) January 2012 to 15(th) January 2013 were collected retrospectively in a predesigned proforma. Risk of having different psychiatric disorders was estimated using odds ratio. The mean age of 120 patients included in this study was 69.67 (SD = 5.94) years. Depressive disorder (26.7%) was the most common diagnosis. There was no statistically significant difference in psychiatric disorders in >75 years compared with ≤75 years except for dementia [odd ratio (OR) (≤75 years/>75 years)=0.055, 95% confidence interval (CI)=0.016; 0.194]. Alcohol dependence syndrome [OR (male/female)=7.826, 95% CI = 1.699;36.705] and dementia [OR (male/female)=3.394, 95% CI = 1.015;11.350] was more common in males. Depressive disorder was the most common psychiatric morbidity among the elderly patients. The odds suffering from dementia increased with increasing age. The odds of having alcohol related problems and dementia were more in males compared with females.Industrial psychiatry journal 07/2014; 23(2):101. DOI:10.4103/0972-6748.151673