The natural history of depression and the anxiety disorders in older people: the Islington community study.
The natural history of depression and the anxiety disorders in older people: the Islington community study.
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老年人抑郁症和焦虑症的自然史：伊斯灵顿社区研究。
DOI：
10.1016/s0165-0327(97)00155-9
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发表时间：
1997
影响因子：
6.6
通讯作者：
Cornelius Katona
中科院分区：
文献类型：
--
作者：
G. Livingston;V. Watkin;Brian Milne;M. Manela;Cornelius Katona
本研究报告了老年人抑郁和焦虑障碍的结果。方法：对165名65岁或以上的受试者进行随访，这些受试者最初是在伦敦市中心的一项社区研究中被确定为抑郁症或焦虑症患者。结果117名受试者仍在本区生活；25人死亡。仅通过首次访谈时的活动限制来预测死亡，而不是通过其他人口统计学或发病率变量。对86名受试者进行了重新访谈；21名男性，65名女性。在抑郁症患者中，34%的人康复了，39%的人抑郁，27%的人死亡。从最初的访谈来看，持续抑郁的预测因子是女性和更严重的抑郁。在那些患有恐惧症焦虑症的人中，16%的人康复了，18%的人死亡，66%的人仍然有恐惧症。女性性别和“独立的”恐惧焦虑（即在初次面试时没有抑郁）是持续恐惧焦虑的预测因子。60%的早期恐惧症患者有特定恐惧症；82%的迟发性恐惧症患者患有广场恐惧症。22名受试者服用精神类药物。精神药物处方的唯一显著预测因子是初次面谈时是否有睡眠障碍。生活满意度低与抑郁显著相关，但与恐惧症无关。得分高与目前没有精神疾病相关。局限性：部分受试者未能随访。服用精神药物的人更有可能拒绝接受采访。结论及临床意义在老年人中，抑郁和焦虑障碍一般不会自行缓解。预后特别差的是女性和那些患有更严重抑郁症的人。广场恐怖症可能在老年人中由压力事件引发，并干扰生活满意度。有可能增加对老年情感性障碍患者的药物治疗。
BackgroundThis study reports the outcome of depression and anxiety disorders in older people.MethodsFollow-up of 165 subjects age 65 or over, initially identified in a community study in inner London as depressed or having an anxiety disorder.Results117 subjects still living in the area; 25 had died. Death was predicted only by activity limitation at first interview and not by other demographic or morbidity variables. Eighty-six subjects reinterviewed; 21 males, 65 females. Of the depressed, 34% had recovered, 39% were depressed and 27% were dead. Predictors from initial interview of continuing depression were female gender and more severe depression. Of those with phobic anxiety, 16% had recovered, 18% died and 66% were still phobic. Predictors of continuing phobic anxiety from initial interview were female gender and “stand-alone” phobic anxiety, i.e., not being depressed at initial interview. Sixty percent of those with early onset phobias had specific phobias; 82% of those with late-onset phobias had agoraphobia. Twenty-two subjects were prescribed psychotropics. The only significant predictor of psychotropic prescription was having sleep disturbance at initial interview. A low score on life satisfaction was significantly correlated with depression but not with phobic disorder. A high score was correlated with not having a current psychiatric disorder.LimitationsSome subjects were lost to follow-up. Those on psychotropics were particularly likely to refuse an interview.Conclusion and clinical relevanceIn older people, neither depression nor the anxiety disorders generally remit spontaneously. Those with a particularly poor prognosis are women and those with a more severe depression. Agoraphobia may be precipitated in older people by stressful events and interferes with life satisfaction. There is potential for increased pharmacological treatment of older people with affective disorders.
DOI：
10.1093/geronj/39.2.166
发表时间：
1984-01-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
GURLAND, B;GOLDEN, RR;CHALLOP, J
通讯作者：
CHALLOP, J