Dysthymia among the community-dwelling elderly.
There are few data on the clinical features of dysthymia among the community-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 scales were used, at a second interview. Comparisons were made with a group of 630 non-depressed elderly from the same community. Dysthymia was predominately 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 in 10%. The dysthymic group had significantly higher degrees of physical impairment than the non-depressed elderly. The symptom profile demonstrated prominent anxiety and functional features. Eighty-three per cent of the elderly with dysthymia had presented to their GP with anxiety/depressive 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 associated with significant degrees of physical impairment. Dysthymia in older people presents to primary care, rather than specialist services, and interventions must be delivered at this level.
Mercer's Institute for Research on Ageing and Dept of Psychiatry for the Elderly, St James's Hospital, Dublin, Ireland.
M
M
Kirby
I
I
Bruce
D
D
Coakley
B A
BA
Lawlor
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D019263:Dysthymic Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D008403:Mass Screening / Q000379:methods; D012494:Sampling Studies