Comparing depression diagnostic symptoms across younger and older adults
Comparing depression diagnostic symptoms across younger and older adults
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DOI：
10.1080/13607860802428000
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发表时间：
2008-01-01
影响因子：
3.4
通讯作者：
Cully, Jeffrey A.
中科院分区：
文献类型：
--
作者：
Balsis, Steve;Cully, Jeffrey A.
目的：老年抑郁症具有潜在的严重影响，并造成沉重的情感、医疗和经济负担。因此，对于治疗老年患者的专业人士来说，识别抑郁症及其晚年症状一直是一个持续的问题，这也就不足为奇了。尽管存在这种担忧，但目前的诊断黄金标准可能不能同样好地识别老年人和年轻人的抑郁症状。这项分析的目的是确定潜伏性抑郁症水平相同的老年人和年轻人是否同样有可能支持特定的DSM诊断症状。方法：采用基于项目反应理论(IRT)的差异项目功能分析方法对DSM抑郁数据进行分析。数据来自1808名老年人(年龄65-98岁)和3734名年轻人(年龄18-34岁)，他们参加了全国酒精中毒及相关疾病流行病学调查。结果：分析结果证实了我们的假设。DSM项目在年轻人和老年人中识别抑郁的方式不同。具体地说，结果显示，与患有同等程度抑郁症的年轻人相比，老年人更有可能支持躯体项目，而不太可能支持认知和自杀项目。结论：这些发现提供了证据，在控制潜在抑郁时，DSM抑郁条目在不同年龄组中的作用不同。然而，重要的是要考虑到，这些调查结果受到抽样方法和实施的特定方案的限制。
Objectives: Depression in later life has potential grave implications and contributes to heavy emotional, medical, and economic burdens. Therefore, it is not surprising that identifying depression and its symptoms in later life has remained a sustained concern for professionals who treat older patients. Despite this concern, the current diagnostic gold standard may not identify depression symptoms equally well in older and younger adults. The objective of this analysis is to determine whether older and younger adults with equivalent levels of latent depression are equally likely to endorse particular DSM diagnostic symptoms. Method: We analyzed DSM depression data using Item Response Theory (IRT)-based differential item functioning analyses. The data came from 1808 older adults (age 65-98 years) and 3734 younger adults (age 18-34 years) who participated in the National Epidemiological Survey on Alcoholism and Related Conditions. Results: The analyses confirmed our hypothesis. The DSM items identify depression differently in younger and older adults. Specifically, results showed that older adults were more likely to endorse somatic items and less likely to endorse cognitive and suicide items than their younger counterparts with equivalent levels of depression. Conclusion: These findings provide evidence that the DSM depression items work differently across age groups when controlling for latent depression. It is important to consider, however, that these findings are limited by the sampling methodology and the particular protocol implemented.