Dysthymia among the community-dwelling elderly

✍ Scribed by Michael Kirby; Irene Bruce; Davis Coakley; Brian A. Lawlor

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 86 KB
• Volume: 14
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(199906)14:6<440::aid-gps936>3.0.co;2-n

✦ Synopsis

There are few data on the clinical features of dysthymia among the community-dwelling elderly. Forty elderly individuals with dysthymic disorder were identi®ed 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 signi®cantly higher degrees of physical impairment than the non-depressed elderly. The symptom pro®le 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 diers from that in earlier life. Late life dysthymia is less associated with axes 1 and 2 comorbidity but is associated with signi®cant degrees of physical impairment. Dysthymia in older people presents to primary care, rather than specialist services, and interventions must be delivered at this level.