Three-Year Incidence and Predictors of First-Onset of DSM-IV Mood, Anxiety, and Substance Use Disorders in Older Adults: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions
Three-Year Incidence and Predictors of First-Onset of DSM-IV Mood, Anxiety, and Substance Use Disorders in Older Adults: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions
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DOI：
10.4088/jcp.09m05618gry
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发表时间：
2011-02-01
影响因子：
5.3
通讯作者：
Sareen, Jitender
中科院分区：
文献类型：
--
作者：
Chou, Kee-Lee;Mackenzie, Corey S.;Sareen, Jitender
目的：本研究的目的是确定老年人情绪障碍、焦虑症和物质使用障碍第四版（DSM-IV）的发病率，并确定这些疾病发病的社会人口学、精神病理学、健康相关和压力相关预测因素。方法：在2000-2001年和2004-2005年的3年时间里，对8012名60岁及以上的社区居民进行了两次全国代表性的抽样调查。使用DSM-IV版《酒精使用障碍和相关残疾访谈表》评估3年内情绪、焦虑和物质使用障碍的首次发生率。结果：3年DSM-IV情绪、焦虑和物质使用障碍的发病率以尼古丁依赖（3.38%）和重度抑郁症（[MDD] 3.28%）最高，药物使用障碍（0.29%）和双相情感障碍（0.34%）最低。老年女性的重度抑郁症（99% CI, 1.22-3.13）和广泛性焦虑症（GAD, 99% CI, 1.20-4.26）的发病率明显更高，老年男性的尼古丁依赖和酒精滥用和依赖的发病率更高。创伤后应激障碍可预测重度抑郁症、双相I型障碍、恐慌症、特定恐惧症和广泛性焦虑症的发病率，而B类人格障碍可预测重度抑郁症、双相I型和II型障碍、恐慌症、社交恐惧症、广泛性焦虑症、尼古丁依赖和酒精依赖的发病率。自我评价不佳的健康状况增加了患重度抑郁症的风险，而肥胖则降低了尼古丁依赖的发生率。结论：关于老年精神疾病的高发生率以及老年人精神疾病发病的危险因素的信息对于有效的早期干预和预防措施非常重要。临床精神病学杂志2011；72(2):144-155 (C)版权所有2011年医师研究生出版社，Inc。
Objective: The aim of this study was to determine the incidence rates of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mood disorders, anxiety disorders, and substance use disorders in older adults and to identify sociodemographic, psychopathological, health-related, and stress-related predictors of onset of these disorders.Method: A nationally representative sample of 8,012 community-dwelling adults aged 60 and above was interviewed twice over a period of 3 years, in 2000-2001 and 2004-2005. First incidence of mood, anxiety, and substance use disorders was assessed over a period of 3 years using the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV Version.Results: The 3-year incidence rates of DSM-IV mood, anxiety, and substance use disorders were highest for nicotine dependence (3.38%) and major depressive disorder ([MDD] 3.28%) and lowest for drug use disorder (0.29%) and bipolar II disorder (0.34%). Incidence rates were significantly greater among older women for MDD (99% CI, 1.22-3.13) and generalized anxiety disorder (GAD; 99% CI, 1.20-4.26) and greater among older men for nicotine dependence and alcohol abuse and dependence. Posttraumatic stress disorder predicted incidence of MDD, bipolar I disorder, panic disorder, specific phobia, and GAD, while Cluster B personality disorders predicted incident MDD, bipolar I and II disorders, panic disorder, social phobia, GAD, nicotine dependence, and alcohol dependence. Poor self-rated health increased the risk for the onset of MDD, whereas obesity decreased the incidence of nicotine dependence.Conclusions: Information about disorders that are highly incident in late life and risk factors for the onset of psychiatric disorders among older adults are important for effective early intervention and prevention initiatives. J Clin Psychiatry 2011;72(2):144-155 (C) Copyright 2011 Physicians Postgraduate Press, Inc.