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在美国国家老年人样本中心境、焦虑和物质障碍的持久患病率与缓解率,以及预测因素

发布时间:2015-08-27 10:17 | 访问量:次 | 来源:未知

Prevalence and predictors of persistent versus remitting mood, anxiety, and substance disorders in a nationalsample of older adults.

作者:Mackenzie CS, El-Gabalawy R, Chou KL, Sareen J.

出处Am J Geriatr Psychiatry. 2014 Sep;22(9):854-65.

摘要

OBJECTIVES:

Relatively little is known about whether mental disorders other than depression remit versus persist in later life, especially within nationally representative samples. Our objectives were to examine the prevalence of persistent mood, anxiety, and substance disorders in olderadults and to explore a range of physical and mental health predictors of disorder chronicity.

METHODS:

This study involved a 3-year follow-up design using Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Participants included 1,994 adults aged 55 years and older who had a past-year mental disorder at Wave 1 and who completed Wave 2. The primary outcome was the prevalence of persistent mood, anxiety, and substance disorders at Wave 2. Potential predictors of persistence included sociodemographic variables, physical health (chronic health conditions and physical health-related quality of life), and mental health (childhood adversity, suicide attempts, mental health-related quality of life, comorbid mental disorders, personality disorders, and lifetime treatment-seeking).

RESULTS:

With the exception of nicotine dependence, the prevalence of persistent mood, anxiety, and substance disorders ranged from 13% to 33%. Only younger age predicted substance disorder chronicity. Significant predictors of persistent mood and anxiety disorders included physical and mental health comorbidity, physical health- and mental health-related quality of life, suicide attempts, comorbid personality disorders, and treatment-seeking.

CONCLUSIONS:

At least two-thirds of mental disorders in these older adults were not persistent. Sociodemographic variables had little influence on chronicity, whereas a number of markers of mental disorder severity and complexity predicted persistent mood and anxiety disorders. The findings have important treatment and prevention implications.

KEYWORDS:

Epidemiology; longitudinal; mental disorders; persistence; remission

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