Dysthymia among the community-dwelling elderly

There are few data on the clinical features of dysthymia among the communit y-dwelling elderly. Forty elderly individuals with dysthymic disorder were identified following screening in the community with GMS-AGECAT. A detailed clinical history was obtained and DSM-IV checklists and standardized scale s were used, at a second interview. Comparisons were made with a group of 6 30 non-depressed elderly from the same community. Dysthymia was predominate ly of late onset (93%) and associated with a major stressor in 65% of cases . Comorbid axis 1 disorders were present in 15% of dysthymics and an axis 2 disorder ill 10%. The dysthymic group had significantly higher degrees of physical impairment than the non-depressed elderly. The symptom profile dem onstrated prominent anxiety and functional features. Eighty-three per cent of the elderly with dysthymia had presented to their CP with anxiety/depres sive symptoms at some stage during the dysthymic disorder. The presentation of dysthymia in older people differs from that in earlier life. Late life dysthymia is less associated with axes 1 and 2 comorbidity but is associate d with significant degrees of physical impairment. Dysthymia in older peopl e presents to primary care, rather than specialist services, and interventi ons must be delivered at this level. Copyright (C) 1999 John Wiley & Sons, Ltd.