Age and sex‐related variability in the presentation of generalized anxiety and depression symptoms

Abstract

Background: Generalized anxiety and depression are extremely prevalent and debilitating. There is evidence for age and sex variability in symptoms of depression, but despite comorbidity it is unclear whether this extends to anxiety symptomatology. Studies using questionnaire sum scores typically fail to address this phenotypic complexity. Method: We conducted exploratory and confirmatory factor analyses on Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) items to identify latent factors of anxiety and depression in participants from the Genetic Links to Anxiety and Depression Study (N = 35,637; 16-93 years). We assessed ageand sex-related variability in latent factors and individual symptoms using multiple logistic regression. Results: Four factors of mood, worry, motor, and somatic symptoms were identified (comparative fit index [CFI] = 0.99, Tucker-Lewis Index [TLI] = 0.99, root mean square error of approximation [RMSEA] = 0.07, standardized root mean square residuals [SRMR] = 0.04). Symptoms of irritability (odds ratio [OR] = 0.81) were most strongly associated with younger age, and sleep change (OR = 1.14) with older age.Males were more likely to report mood and motor symptoms (p < .001) and females to report somatic symptoms (p < .001). Conclusion:Significant age and sex variability suggest that classic diagnostic criteria reflect the presentation most commonly seen in younger males. This study provides avenues for diagnostic adaptation and factor-specific interventions.

Low and mismatched socioeconomic status between newlyweds increased their risk of depressive symptoms: A multi-center study

“…Furthermore, demographic information and PHQ-9 scores were obtained through a self-assessment questionnaire, which may lead to reporting bias. However, the PHQ-9 is a self-administered instrument validated for screening, diagnosis, and assessment of the severity of depressive symptoms with good psychometric properties ( 30 ) and has been widely used in previous studies ( 42 – 44 ). Moreover, to increase the credibility of the questionnaire, two reverse quality control items were added to the PHQ-9 scale during the survey.…”

Validating repurposed GAD‐7 anchored in COVID‐19 pandemic experiences: A factor‐ and person‐centered approach

“…The internally accumulated distress experienced by males will most likely be manifested through physical symptoms (e.g., bodily pains, trouble relaxing), thus plausibly endorsing more somatic symptoms of anxiety. Whereas for females, their symptom presentation of anxiety was found to incline more toward the cognitive-emotional facet of anxiety (Armstrong & Khawaja, 2002;Thompson et al, 2021). They were found to present excessive worry and difficulty controlling their anxiety (Thompson et al, 2021).…”

“…Whereas for females, their symptom presentation of anxiety was found to incline more toward the cognitive-emotional facet of anxiety (Armstrong & Khawaja, 2002;Thompson et al, 2021). They were found to present excessive worry and difficulty controlling their anxiety (Thompson et al, 2021). This may be credited to the notion that females are more likely to focus on the emotional aspects of a distressing situation, have a higher appraisal of threat (i.e., likely to expect harm), have elevated emotional expressivity of their negative experiences, and have a greater tendency to engage in repetitive thinking (McLean & Anderson, 2009;Zlomke & Hahn, 2010).…”

Association Between Cardiorespiratory Fitness and Incident Purchase of Hypnotic Drugs in Adults: The HUNT Study

“…Importantly, major depressive disorders and anxiety disorders often overlap, and insomnia is prevalent in both conditions. 63 We did not have access to medical records or indication for prescription; thus, specific medical diagnoses under medical treatment at baseline, such as cancer, as well as substance use and some sleep disorders may have influenced CRF through decreased PA level, thereby causing a further need for medical treatment of sleep problems, suggesting that CRF may not be directly related to incident use of prescribed hypnotics. Nevertheless, we believe that the exclusion of participants purchasing hypnotics several years before baseline and in the first 3 months of follow-up reduced the risk for reverse causality.…”