Prevalence Of Latelife Depression And Anxiety

The Epidemiological Catchment Area Study (ECA) (Regier et al., 1988) was a major study investigating rates of depression and anxiety in the community carried out across five sites in the US. The ECA prevalence rates of major depressive disorder amongst older adults were lower than for younger adults (for review see Powers et al., 2002). In the UK, Lindesay, Brigs & Murphy (1989) reported prevalence rates of 4.3 % for severe depression and 13.5 % for mild/moderate depression in a community dwelling urban sample. Beekman, Copeland & Prince (1999) carried out a systematic review of community-based studies examining prevalence of depression in older adults. Overall, Beekman, Copeland & Prince (1999) calculated prevalence rates of 13.5 % for clinically relevant depression but concluded that major depression is relatively rare in later life (1.8 %) whereas minor depression is relatively more common (9.8 %). Similar figures reported by Copeland et al. (1987) and Livingston et al. (1990) have led to a number of authors suggesting that minor rather than major depressive disorder may be more common in older people (Beekman et al., 2002; Blazer, 2002). Minor depression (Blazer, 2002) may still have a major impact on a person's quality of life (Alexopoulos, 2001; Zarit & Zarit, 1998).

Depression is often thought of as the common cold of geriatric mental health but Blazer (1997) states that anxiety is more common than major depression in later life. Using data from the ECA, Regier et al. (1988) reported one-month prevalence rates of 5.5 % for older adults. As with depression, anxiety was less common in later life as the prevalence rate was 7.3 % for younger adults (for review see Powers et al., 2002). Lindesay, Brigs & Murphy (1989) reported prevalence rates of 10 % overall for anxiety disorders in their older adults sample. In older people, generalized anxiety disorder (GAD) and the phobias (agoraphobia, social phobia, simple phobia) are considered more common than other anxiety disorders such as panic disorder, obsessive-compulsive disorder and post-traumatic disorder (Stanley & Beck, 2000). Although phobias are the most common form of anxiety disorder among older people, social anxiety is much less prevalent in older people when compared to younger people (Gretarsdottir et al., 2004). As with depression, there is a suggestion that sub-syndromal levels of anxiety, particularly GAD, are common in older people and that minor GAD symptoms may cause enough problems to merit attention from clinicians (Carter et al., 2001; Diefenbach et al., 2003; Wetherell, LeRoux & Gatz, 2003).

Generally rates of depression and anxiety change depending on the characteristics of the sample with higher rates of anxiety and depression reported for non-community dwelling samples (Katz et al., 1989; Kogan et al., 2000). Prevalence rates increase when physical health conditions are taken account of, although it is a mistake to assume that lack of physical health automatically results in psychological distress (Zeiss et al., 1996). Many older people do not consider themselves ill even if they are prescribed multiple medications and in the eyes of their physicians are seen as chronically ill (Valliant & Mukamal, 2001) as older people generally accommodate to chronic illness over very many years (Laidlaw et al., 2003). The physical decline that may be seen in old age is, according to Valliant & Mukamal (2001), confined to the last few years of life.

There is a general consensus that depression and anxiety in older people have a poor prognosis with low rates of spontaneous remission (Beckman et al. 2002; Cole, Bellavance & Mansour, 1999; Livingston et al., 1997). Depression and anxiety in later life, are often under-detected and under-treated. Treatments primarily are medication-based and this may be considered problematic in terms of their side-effects profile (Blazer, 1997). Fears about tolerability of medication in older people often result in the prescription of medications at sub-therapeutic levels thus diluting their potential effectiveness (Alexoponlos, 2001; Blazer, 1997; Isometsa etal., 1998; Laidlaw, 2003; Nelson 2001; Orrell etal., 1995; Small, 1997). The foregoing provides the rationale for examining whether psychological treatments for depression and anxiety are efficacious for older people.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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