title: The impact of DSM-IV symptom and clinical significance criteria on the prevalence estimates of subthreshold and threshold anxiety in the older adult population.
abstract: OBJECTIVE
  Subthreshold anxiety refers to a condition where individuals do not meet the full symptom criteria (i.e., the number of symptoms required for a formal diagnosis is not reached) and/or do not report significant impairment or distress in functioning (i.e., the clinical significance criterion is not met). The purpose of this study was to examine how the symptom and the clinical significance criteria may affect the prevalence estimates of anxiety problems in the older adult population and whether applying these criteria results in an identifiable older group showing more severe anxiety.
  
  
  METHODS
  Data came from a large representative sample of community-dwelling older adults age 65 years and older (N = 2,784).
  
  
  RESULTS
  Results showed that the 12-month prevalence rate of any anxiety problem varied from 5.6% when DSM-IV criteria for anxiety disorders were used to 26.2% when all subthreshold manifestations of anxiety were considered. Findings also indicated that when compared with respondents without anxiety, older adults presenting different manifestations of subthreshold or threshold anxiety appear to be more similar than different in their health and health behavior characteristics.
  
  
  CONCLUSIONS
  Subthreshold anxiety has a high prevalence and may cause significant impairment. Both symptom and clinical significance criteria do not perfectly discriminate between older adults with or without a severe anxiety problem presenting comorbid disorders and needing psychiatric help.
authors.affiliation: Centre de recherche de l'Hôpital Charles Lemoyne, Université de Sherbrooke, Greenfield Park, Quebec, Canada. sebastien.grenier2@usherbrooke.ca
authors.forename: Sébastien
authors.initials: S
authors.lastname: Grenier
authors.forename: Michel
authors.initials: M
authors.lastname: Préville
authors.forename: Richard
authors.initials: R
authors.lastname: Boyer
authors.forename: Kieron
authors.initials: K
authors.lastname: O'Connor
authors.forename: Sarah-Gabrielle
authors.initials: SG
authors.lastname: Béland
authors.forename: Olivier
authors.initials: O
authors.lastname: Potvin
authors.forename: Carol
authors.initials: C
authors.lastname: Hudon
authors.forename: Joëlle
authors.initials: J
authors.lastname: Brassard
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies / Q000379:methods*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012959:Socioeconomic Factors