Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity
Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity
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DOI：
10.1017/s0033291708003413
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发表时间：
2008-11-01
影响因子：
6.9
通讯作者：
Williams, D.
中科院分区：
文献类型：
--
作者：
Scott, K. M.;von Korff, M.;Williams, D.
背景。身体发病率是抑郁症发病的一个潜在危险因素，并且随着年龄的增长而明显增加，但先前的研究经常发现抑郁症会随着年龄的增长而减少。这项研究测试了年龄和精神障碍之间的关系随着身体共病而不同的可能性。方法。作为世界心理健康 (WMH) 调查计划的一部分，对住户成年人进行了 18 项一般人口调查（n = 42 697）。 DSM-IV 疾病通过综合国际诊断访谈 (CIDI 3.0) 的面对面访谈进行评估。年龄对伴有或不伴有身体或疼痛共病的 12 个月抑郁症和/或焦虑症以及不伴有精神共病的身体和/或疼痛状况的影响进行了估计。结果。抑郁症和焦虑症随着年龄的增长而减少，这一结果无法用器质性排除标准来解释。作为身体/疼痛共病的函数，精神障碍和年龄之间的关系没有发现显着差异。大多数老年人患有慢性身体或疼痛疾病，但没有共病精神障碍；相比之下，大多数精神障碍患者都患有身体/疼痛共病，特别是在老年人群中。结论。尽管随着年龄的增长，身体发病率大大增加，但 CIDI 诊断的普通人群抑郁症和焦虑症随着年龄的增长而减少。精神障碍患者的身体发病是常态，特别是在老年人群中。卫生专业人员，包括心理卫生专业人员，需要解决精神障碍患者身体共病管理的障碍。
Background. Physical morbidity is a potent risk factor for depression onset and clearly increases with age, yet prior research has often found depressive disorders to decrease with age. This study tests the possibility that the relationship between age and mental disorders differs as a function of physical co-morbidity.Method. Eighteen general population surveys were carried out among household-residing adults as part of the World Mental Health (WMH) surveys initiative (n = 42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). The effect of age was estimated for 12-month depressive and/or anxiety disorders with and without physical or pain co-morbidity, and for physical and/or pain conditions without mental co-morbidity.Results. Depressive and anxiety disorders decreased with age, a result that cannot be explained by organic exclusion criteria. No significant difference was found in the relationship between mental disorders and age as a function of physical/pain co-morbidity. The majority of older persons have chronic physical or pain conditions without co-morbid mental disorders; by contrast, the majority of those with mental disorders have physical/pain co-morbidity, particularly among the older age groups.Conclusions. CIDI-diagnosed depressive and anxiety disorders in the general population decrease with age, despite greatly increasing physical morbidity with age. Physical morbidity among persons with mental disorder is the norm, particularly in older populations. Health professionals, including mental health professionals, need to address barriers to the management of physical co-morbidity among those with mental disorders.