Dysthymia among the community-dwelling elderly

Author(s): Bruce, I., Coakley, D., Lawlor, B. A.

Journal/Book: Int J Geriat Psychiat. 1999; 14: Baffins Lane Chichester, W Sussex PO19 1UD, England. John Wiley & Sons Ltd. 440-445.

Abstract: 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 ill 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 CP 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.

Note: Article Kirby M, St James Hosp, Mercers Inst Res Ageing, Dublin 8, IRELAND

Keyword(s): dysthymia; depression; elderly; community; primary care; comorbidity; treatment; THREATENING EXPERIENCES; MENTAL STATE; DSM-III; DEPRESSION; DISORDER; LIFE; RELIABILITY; OUTPATIENTS; AGECAT; LIST

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