Anxiety and Depression among Elderly Public Housing Residents

公屋长者的焦虑及抑郁情况

• 批准号: 7774714
• 负责人: Adam C Simning
• 金额: $ 0.64万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7774714
• 关键词: Anxiety; Depression; among; Elderly; Public

DESCRIPTION (provided by the applicant): Background: Anxiety and depression in socioeconomically disadvantaged older adults frequently go unrecognized and untreated. There is a great need for new cost-effective community programs that improve detection and treatment of late-life anxiety and depression. Elderly public housing high-rises are a promising venue to develop and test such programs due to the high concentration of older adults with many risk factors. Few studies, however, have taken advantage of the potential opportunities these high-rises offer, and further work is needed to characterize anxiety, depression, mental health needs, and service utilization patterns in this population. Research Aims: The proposed study will examine anxiety and depression in elderly residents of public housing high-rises. Aim 1 is to evaluate syndromal and subsyndromal anxiety and depression prevalence and unmet mental healthcare need, as well as the correlates of anxiety and depression symptom severity; subsyndromal conditions occur when there are clinically significant levels of symptoms, but full syndromal diagnostic criteria are unmet. A secondary aim is to establish the sensitivity and specificity of brief anxiety and depression questionnaires in this setting. Aim 2 is to develop statistical models characterizing the association of anxiety and depression symptom severity with utilization of on-site aging services social workers, formal services, and informal services after accounting for demographic and other additional factors. We hypothesize that severity of anxiety and depression symptoms is positively associated with utilization of on-site social workers, formal services, and informal services. Study Design: The Rochester Housing Authority devotes four public housing high-rises to older adults in Rochester, NY. We will conduct a two-stage cross-sectional study and aim to recruit 174 public housing high-rise residents aged 60 years and older. During the first stage all residents living in the older adult high- rises will receive a brief general health questionnaire. We will provide residents with assistance in completing the questionnaire because illiteracy may be a barrier for some. Residents can elect to participate in a second stage survey, which will include all English-speaking residents aged 60 years and older who volunteer. The second stage consists of an in-depth, in-person interview that will assess anxiety and depression, demographics, early and current achievement, social integration, vulnerability/protective factors, life events, and coping methods, as well as service utilization. Anxiety and depression will be characterized categorically (i.e., syndromal and subsyndromal conditions) and dimensionally (i.e., symptom severity). We will use the Structured Clinical Interview for the DSM-IV (SCID) to diagnostically assess anxiety and depression, as well as brief survey scales to measure anxiety and depression symptom severity. Descriptive statistics and multiple regression modeling will address our aims. To our knowledge, this study will be the first to examine subsyndromal anxiety and depression, characterize on-site social worker utilization, and conduct an in-depth analysis of social engagement and support in elderly public housing residents; partial replication of a previous work describing psychiatric disorder prevalence, correlates, and service utilization in this setting will be additional contributions. Findings from the proposed research should be instrumental in describing the mental health burden and needs of this primarily minority population. Furthermore, this research may generate a novel and sustainable aging services-based method for using on-site social workers to increase access to care by identifying, referring (to existing primary care and behavioral health networks), or providing on-site care for anxious and depressed elderly public housing residents.

背景：社会经济条件不利的老年人的焦虑和抑郁经常未被发现和治疗。我们非常需要新的、具有成本效益的社区项目来改善对晚年焦虑和抑郁的检测和治疗。老年公共住房高层是开发和测试此类项目的理想场所，因为老年人高度集中，存在许多风险因素。然而，很少有研究利用了这些高层建筑提供的潜在机会，需要进一步的工作来描述这一人群的焦虑、抑郁、心理健康需求和服务利用模式。研究目的：本研究旨在探讨公屋高层长者的焦虑与抑郁。目的1：评估综合征和亚综合征焦虑和抑郁患病率、未满足的精神卫生保健需求，以及焦虑和抑郁症状严重程度的相关性；当有临床显著水平的症状，但不满足完整的综合征诊断标准时，就会出现亚综合征性疾病。第二个目的是在这种情况下建立简短的焦虑和抑郁问卷的敏感性和特异性。目标2是在考虑人口统计和其他附加因素后，建立统计模型，描述焦虑和抑郁症状严重程度与现场老龄服务社工、正式服务和非正式服务的利用之间的关系。我们假设焦虑和抑郁症状的严重程度与使用现场社会工作者、正式服务和非正式服务呈正相关。研究设计：罗彻斯特住房管理局为纽约州罗彻斯特的老年人建造了四栋高层公共住房。我们将进行两阶段的横断面研究，目标是招募174名60岁及以上的公屋高层住户。在第一阶段，所有居住在老年高层建筑的居民将收到一份简短的健康问卷。我们将协助居民填写问卷，因为文盲可能是一些人的障碍。居民可以选择参加第二阶段的调查，这将包括所有60岁及以上的英语居民自愿参加。第二阶段包括深入的面对面访谈，评估焦虑和抑郁、人口统计、早期和当前的成就、社会融合、脆弱性/保护因素、生活事件、应对方法以及服务利用。焦虑和抑郁将被分类（即综合征和亚综合征状况）和维度（即症状严重程度）表征。我们将使用DSM-IV （SCID）中的结构化临床访谈来诊断评估焦虑和抑郁，并使用简短的调查量表来测量焦虑和抑郁症状的严重程度。描述性统计和多元回归建模将解决我们的目标。据我们所知，本研究将首次对老年公共住房居民的亚症候群焦虑和抑郁、现场社工利用特征、社会参与和社会支持进行深入分析；部分复制先前的工作描述精神疾病的患病率，相关因素，并在这种情况下的服务利用将是额外的贡献。拟议研究的结果应有助于描述这主要是少数民族人口的心理健康负担和需求。此外，本研究可能会产生一种新的、可持续的基于老龄化服务的方法，利用现场社会工作者通过识别、参考（现有的初级保健和行为健康网络）或为焦虑和抑郁的老年公共住房居民提供现场护理来增加获得护理的机会。

项目成果

Comparison of different scoring methods based on latent variable models of the PHQ-9: an individual participant data meta-analysis.

• DOI: 10.1017/s0033291721000131
• 发表时间: 2021-02-22
• 期刊: PSYCHOLOGICAL MEDICINE
• 影响因子: 6.9
• 作者: Fischer, Felix;Levis, Brooke;Falk, Carl;Sun, Ying;Ioannidis, John P. A.;Cuijpers, Pim;Shrier, Ian;Benedetti, Andrea;Thombs, Brett D.
• 通讯作者: Thombs, Brett D.

Probability of Major Depression Classification Based on the SCID, CIDI, and MINI Diagnostic Interviews: A Synthesis of Three Individual Participant Data Meta-Analyses.

• DOI: 10.1159/000509283
• 发表时间: 2021
• 期刊: Psychotherapy and psychosomatics
• 影响因子: 22.8
• 作者: Wu Y;Levis B;Ioannidis JPA;Benedetti A;Thombs BD;DEPRESsion Screening Data (DEPRESSD) Collaboration
• 通讯作者: DEPRESsion Screening Data (DEPRESSD) Collaboration