Title:
|
An examination of mood and anxiety disorders across the adult
lifespan using multiple group methods:
the EU-WMH project
|
The purpose of the study was to examine the reported prevalence of mood and anxiety disorders
along the adult lifespan in a number of European countries and to consider whether the low
prevalence of these disorders often reported by standardised diagnostic instruments in later life
was likely to be realistic.
Methods
Data from the European Union World Mental Health (EU-WMH) project, a cross-national study
of 37,289 adults from ten European countries assessed using the Composite International
Diagnostic Interview (CIDI) were analysed. A multiple group methodology was used to model
all relationships with age, with the countries forming the groups. Analyses included logistic
regression, multinomial regression, Poisson regression, latent class analysis and confirmatory
factor analysis. This was a much wider examination of the suitability of multiple group methods
for cross-national research than has traditionally been the case within psychiatric epidemiology.
Sociodemographic variables were included as appropriate.
Results
In most countries adults over 80 years of age were unlikely to be diagnosed with any l2-month
DSM-IV mood or anxiety disorder. The 12-month prevalence of individual disorders, disorder
groupings, and latent classes of disorders typically declined with age among older adults in
Western Europe and increased with age in Eastern Europe but this was not always the case. The
burden associated with double depression increased with age in a number of countries. Older
adults in Western Europe were those least likely to endorse any of the lifetime mood and
anxiety screening questions. They were also those least likely to receive at least a lifetime
diagnosis of major depressive episode or endorse the minimum episode duration requirements
assessed at the start of the depression module. There were no significant relationships between
the latent construct for major depressive episode, the symptom groups and age in any country.
Conclusions
Multiple group methods form an attractive strategy for the cross-national study of both observed
and latent variables. The prevalence of mood and anxiety disorders in later life as reported by
the CIDI does not correspond with other sources. It is debateable whether some of the reporting
patterns observed among older adults, such as responses to lifetime screening questions 01' the
minimum duration requirements, are likely to be realistic. We recommend that validity studies
of the CIDI and sensitivity analyses of the screener specifically take place among older adults in
a number of countries, not least within Eastern Europe.
|