Further research in the question of whether OCD is just a "different form of depression" or whether they are better described as comorbid turned these articles up. Hardly any dramatic changes such as changing OCD from an anxiety to a mood disorder...OBJECTIVE: The author reviewed the epidemiology and comorbidity of anxiety disorders in the elderly. METHOD: Data from 1970 onward were obtained through a computerized literature search, a review of Index Medicus, and the bibliographies of retrieved articles. Eight random-sample community surveys of anxiety disorders in persons 60 years of age or older were identified. Studies relating to the comorbidity of late-life anxiety and depression, dementia, alcoholism, and medical illness were also reviewed. RESULTS: The majority of studies showed that anxiety disorders are less common in the elderly than in younger adults. Generalized anxiety disorder and phobias account for most anxiety in late life; panic disorder is rare. Agoraphobia, and possibly obsessive-compulsive disorder in females, may occur as a primary disorder for the first time in old age, whereas simple phobia, obsessive-compulsive disorder in males, and panic disorder either persist from younger years or arise in the context of another psychiatric or medical disorder. There is considerable comorbidity of geriatric depression and generalized anxiety disorder and phobias, although the depression usually goes untreated or is inappropriately treated with benzodiazepines. The rate of comorbidity of anxiety and medical illness and alcoholism is lower in the elderly than in younger persons. CONCLUSIONS: Epidemiologic data on the prevalence of posttraumatic stress disorder (PTSD) and the first occurrence of generalized anxiety disorder and PTSD in late life are still needed. Further comorbidity studies are needed to determine the extent to which anxiety arises secondary to depression, as well as the optimal treatment and prognosis for this mixed state.
Beth Benoit
University System of New Hampshire
Portsmouth campuses
Symptoms of anxiety and symptoms of depression. Same genes, different environments?
Kendler KS, Heath AC, Martin NG, Eaves LJ
Arch Gen Psychiatry 1987 May;44(5):451-7
While traditional multivariate statistical methods can describe patterns of psychiatric symptoms, they cannot provide insight into why certain symptoms tend to co-occur in a population. However, this can be achieved using recently developed methods of multivariate genetic analysis. Examining self-report symptoms in a clinically unselected twin sample (3798 pairs), traditional factor analysis indicates that symptoms of depression and anxiety tend to form separate symptom clusters. Multivariate genetic analysis shows that genes act largely in a nonspecific way to influence the overall level of psychiatric symptoms. No evidence could be found for genes that specifically affect symptoms of depression without also strongly influencing symptoms of anxiety. By contrast, the environment seems to have specific effects, ie, certain features of the environment strongly influence symptoms of anxiety while having little impact on symptoms of depression. These results, which are replicated across sexes, suggest that the separable anxiety and depression symptom clusters in the general population are largely the result of environmental factors.
PMID: 3579496, UI: 87212381
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Epidemiology and comorbidity of anxiety disorders in the elderly.
Flint AJ
Department of Psychiatry, Toronto General Hospital, Ont., Canada.
Am J Psychiatry 1994 May;151(5):640-9
Title: Comorbidity of depression and OCD?
