Comorbid anxiety disorders in depressed elderly patients

Objective: Anxiety disorders are common in adults with depressive disorders , but several studies have suggested a relatively low prevalence of anxiety disorders in older individuals with depression. This cross-sectional study measured current and lifetime rates and associated clinical features of an xiety disorders in depressed elderly patients. Method: History of anxiety disorders was assessed by using a structured dia gnostic instrument in 182 depressed subjects aged 60 and older seen in prim ary care and psychiatric settings. Associations between comorbid anxiety di sorders and baseline characteristics were measured. The modified structured instrument allowed detection of symptoms that met inclusion criteria for g eneralized anxiety disorder in a depressive episode. Results: Thirty-five percent of older subjects with depressive disorders ha d at least one lifetime anxiety disorder diagnosis, and 23% had a current d iagnosis. The most common current comorbid anxiety disorders were panic dis order (9.3%), specific phobias (8.8%), and social phobia (6.6%). Symptoms t hat met inclusion criteria for generalized anxiety disorder, measured separ ately, were present in 27.5% of: depressed subjects. Presence of a comorbid anxiety disorder was associated with poorer social function and a higher l evel of somatic symptoms. Symptoms of generalized anxiety disorder were ass ociated with a higher level of suicidality. Conclusions: Contrary to previous reports, the present study found a relati vely high rate of current and lifetime anxiety disorders in elderly depress ed individuals. Comorbid anxiety disorders and symptoms of generalized anxi ety disorder were associated with a more severe presentation of depressive illness in elderly subjects.