Subsyndromal depression and anxiety in older adults: Health related, functional, cognitive and diagnostic implications
Open accessAbstract
Subsyndromal depression in later life is common in primary care. Comorbid anxiety disorders could exacerbate the negative effect of subsyndromal depression on functioning, health-related quality of life, comorbidity and/or cognition. We examined anxiety disorders co-existing with subsyndromal depression in participants ≥ age 50 in an NIH trial of Problem Solving Therapy for Primary Care for indicated prevention of major depression. There were 247 participants, with Centers for Epidemiologic Studies - Depression scores ≥ 11. Participants could have multiple psychiatric diagnoses: 22% of the sample had no DSM IV diagnosis; 39% of the sample had only 1 DSM IV diagnosis; 28% had 2 diagnoses; 6% had 3 DSM IV diagnoses; 4% had 4 DSM IV diagnoses; and 1% had 5 diagnoses. Furthermore, 34% of participants had a current comorbid DSM IV diagnosis of a syndromal anxiety disorder. We hypothesized that those with subsyndromal depression, alone relative to those with co-existing anxiety disorders, would report better health-related quality of life, less disability, less medical comorbidity and less cognitive impairment. However, there were no differences in quality of life based on the SF 12 nor in disability based on Late Life Function and Disability Instrument scores. There were no differences in medical comorbidity based on the Cumulative Illness Scale-Geriatrics scale scores nor in cognitive function based on the Executive Interview (EXIT), Hopkins Verbal Learning Test-Revised and Mini-Mental Status Exam. Our findings suggest that about one third of participants 50 years and older with subsyndromal depression have comorbid anxiety disorders; however, this does not appear to be associated with worse quality of life, functioning, disability, cognitive function or medical comorbidity.
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Subsyndromal mental health symptoms are broadly regarded as risk factors for developing clinically significant mental health disorders.
“the subsyndromal mental health symptoms (e.g., subsyndromal depression, subsyndromal generalized anxiety disorder, subsyndromal PTSD), failing to meet the full diagnostic criteria of mental health disorders, are broadly regarded as risk factors for developing clinically significant mental health disorders [190–192].”
From Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis (2022) · cites this paper as [191]
The population with subsyndromal mental health symptoms is underdiagnosed and undertreated globally, which results in public health hazards.
“However, the population with subsyndromal mental health symptoms is underdiagnosed and undertreated globally, which results in public health hazards [190–192].”
From Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis (2022) · cites this paper as [191]
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The association of comorbid depression and anxiety symptoms with disability onset in older adults
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- Authors
- Kasckow, J. W., Karp, J. F., Whyte, E., Butters, M., Brown, C., Begley, A., Bensasi, S., & Reynolds, C. F.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Kasckow, J.W.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 47
- Issue
- 5
- Pages
- 599-603
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC3594429
- OpenAlex
- W1975691250
- Cited by
- 24
- References
- 28
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 5 · 2013: 1
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eli Lilly and Company
- National Institutes of Health (UL1TR000005, KL2TR000146)
- National Institute on Aging (R01AG033575, AG033575)
- National Institute of Mental Health (P30MH090333)
- National Center for Advancing Translational Sciences
- National Institute on Minority Health and Health Disparities (P60MD000207)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- subthreshold depression, geriatric depression, anxiety disorders, comorbidities, older adults, health-related quality of life, functional disability, cognitive impairment, problem-solving therapy, primary care, depression prevention
- MeSH terms
- Aged, Aged, 80 and over, Anxiety, Cognition Disorders, Depression, Female, Humans, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Quality of Life, Statistics as Topic, Comorbidity, Single-Blind Method, Diagnostic and Statistical Manual of Mental Disorders, Self Report
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