Mood and anxiety disorders across the adult lifespan: a European perspective

McDowell, Ronald; Ryan, Arthur T.; Bunting, Brendan; O’Neill, Siobhan; Alonso, Jordi; Bruffærts, Ronny; Graaf, Ron de; Florescu, Silvia; Vilagut, Gemma; Almeida, José Miguel Caldas de; Girolamo, Giovanni de; Haro, Josep María; Hinkov, Hristo; Kovess-Masfety, Viviane; Matschinger, Herbert; Томов, Тома

doi:10.1017/s0033291713001116

Cited by 15 publications

(7 citation statements)

References 59 publications

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“…The socio-demographic associations documented here are broadly consistent with previous studies in finding higher rates of both anxiety disorders and MDD among women (Parker and Brotchie, 2010; Altemus et al 2014) and the previously-married (Scott et al 2010; Leach et al 2013) along with less consistent inverse associations with age (de Graaf et al 2013; McDowell et al 2014). However, we are unaware of prior systematic efforts to examine nested associations in the way we did here.…”

Section: Discussionsupporting

confidence: 90%

Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys

Kessler

Sampson²,

Berglund³

et al. 2015

Epidemiol Psychiatr Sci

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415

242

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AIMS To examine cross-national patterns and correlates of lifetime and 12-month comorbid DSM-IV anxiety disorders among people with lifetime and 12-month DSM-IV major depressive disorder (MDD). METHODS Nationally or regionally representative epidemiological interviews were administered to 74,045 adults in 27 surveys across 24 countries in the WHO World Mental Health (WMH) Surveys. DSM-IV MDD, a wide range of comorbid DSM-IV anxiety disorders, and a number of correlates were assessed with the WHO Composite International Diagnostic Interview (CIDI). RESULTS 45.7% of respondents with lifetime MDD (32.0–46.5% inter-quartile range [IQR] across surveys) had one of more lifetime anxiety disorders. A slightly higher proportion of respondents with 12-month MDD had lifetime anxiety disorders (51.7%, 37.8–54.0% IQR) and only slightly lower proportions of respondents with 12-month MDD had 12-month anxiety disorders (41.6%, 29.9–47.2% IQR). Two-thirds (68%) of respondents with lifetime comorbid anxiety disorders and MDD reported an earlier age-of-onset of their first anxiety disorder than their MDD, while 13.5% reported an earlier age-of-onset of MDD and the remaining 18.5% reported the same age-of-onset of both disorders. Women and previously married people had consistently elevated rates of lifetime and 12-month MDD as well as comorbid anxiety disorders. Consistently higher proportions of respondents with 12-month anxious than non-anxious MDD reported severe role impairment (64.4% vs. 46.0%; χ21=187.0, p<.001) and suicide ideation (19.5% vs. 8.9%; χ21=71.6, p<.001). Significantly more respondents with 12-month anxious than non-anxious MDD received treatment for their depression in the 12 months before interview, but this difference was more pronounced in high income countries (68.8% vs. 45.4%; χ21=108.8, p<.001) than low/middle income countries (30.3% vs. 20.6%; χ21=11.7, p<.001). CONCLUSIONS Patterns and correlates of comorbid DSM-IV anxiety disorders among people with DSM-IV MDD are similar across WMH countries. The narrow IQR of the proportion of respondents with temporally prior AOO of anxiety disorders than comorbid MDD (69.6–74.7%) is especially noteworthy. However, the fact that these proportions are not higher among respondents with 12-month than lifetime comorbidity means that temporal priority between lifetime anxiety disorders and MDD is not related to MDD persistence among people with anxious MDD. This, in turn, raises complex questions about the relative importance of temporally primary anxiety disorders as risk markers versus causal risk factors for subsequent MDD onset and persistence, including the possibility that anxiety disorders might primarily be risk markers for MDD onset and causal risk factors for MDD persistence.

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Section: Discussionsupporting

confidence: 90%

Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys

Kessler

Sampson²,

Berglund³

et al. 2015

Epidemiol Psychiatr Sci

Self Cite

415

242

View full text Add to dashboard Cite

show abstract

“…We had identified the elderly as a priority group a priori because of their higher risks of social isolation, lack of digital connectivity and greater vulnerability to COVID-19. However, similar to other research that has consistently found declining prevalence of mental disorders with increasing age [45][46][47], in NZ older people appeared to be faring better than younger people. This is not to say older people were unscathed.…”

Section: Examination Of Vulnerable Groupssupporting

confidence: 86%

Psychological distress, anxiety, family violence, suicidality, and wellbeing in New Zealand during the COVID-19 lockdown: A cross-sectional study

et al. 2020

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New Zealand’s early response to the novel coronavirus pandemic included a strict lockdown which eliminated community transmission of COVID-19. However, this success was not without cost, both economic and social. In our study, we examined the psychological wellbeing of New Zealanders during the COVID-19 lockdown when restrictions reduced social contact, limited recreation opportunities, and resulted in job losses and financial insecurity. We conducted an online panel survey of a demographically representative sample of 2010 adult New Zealanders in April 2020. The survey contained three standardised measures–the Kessler Psychological Distress Scale (K10), the GAD-7, and the Well-Being Index (WHO-5)–as well as questions designed specifically to measure family violence, suicidal ideation, and alcohol consumption. It also included items assessing positive aspects of the lockdown. Thirty percent of respondents reported moderate to severe psychological distress (K10), 16% moderate to high levels of anxiety, and 39% low wellbeing; well above baseline measures. Poorer outcomes were seen among young people and those who had lost jobs or had less work, those with poor health status, and who had past diagnoses of mental illness. Suicidal ideation was reported by 6%, with 2% reporting making plans for suicide and 2% reporting suicide attempts. Suicidality was highest in those aged 18–34. Just under 10% of participants had directly experienced some form of family harm over the lockdown period. However, not all consequences of the lockdown were negative, with 62% reporting ‘silver linings’, which included enjoying working from home, spending more time with family, and a quieter, less polluted environment. New Zealand’s lockdown successfully eliminated COVID-19 from the community, but our results show this achievement brought a significant psychological toll. Although much of the debate about lockdown measures has focused on their economic effects, our findings emphasise the need to pay equal attention to their effects on psychological wellbeing.

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“…There is a substantial body of literature showing that adult inhabitants of urban areas are more likely to be diagnosed with a psychiatric disorder compared to those living in more rural areas [11,[15][16][17]. Retrospective studies showed that this increased risk for mental health problems may be even greater for those who grew up in a city [18], suggesting that the effects of an urban environment on mental health may be particularly influential during youth.…”

Section: Urbanicity and Mental Healthmentioning

confidence: 99%

Urbanicity, biological stress system functioning and mental health in adolescents

et al. 2020

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Growing up in an urban area has been associated with an increased chance of mental health problems in adults, but less is known about this association in adolescents. We examined whether current urbanicity was associated with mental health problems directly and indirectly via biological stress system functioning. Participants (n = 323) were adolescents from the Dutch general population. Measures included home and laboratory assessments of autonomic nervous system and hypothalamic-pituitary-adrenal axis functioning, neighborhood-level urbanicity and socioeconomic status, and mother-and adolescent selfreported mental health problems. Structural equation models showed that urbanicity was not associated with mental health problems directly. Urbanicity was associated with acute autonomic nervous system and hypothalamic-pituitary-adrenal axis reactivity such that adolescents who lived in more urban areas showed blunted biological stress reactivity. Furthermore, there was some evidence for an indirect effect of urbanicity on mother-reported behavioral problems via acute autonomic nervous system reactivity. Urbanicity was not associated with overall autonomic nervous system and hypothalamic-pituitary-adrenal axis reactivity or basal hypothalamic-pituitary-adrenal axis functioning. Although we observed some evidence for associations between urbanicity, biological stress reactivity and mental health problems, most of the tested associations were not statistically significant. Measures of long-term biological stress system functioning may be more relevant to the study of broader environmental factors such as urbanicity.

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Mood and anxiety disorders across the adult lifespan: a European perspective

Cited by 15 publications

References 59 publications

Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys

Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys

Psychological distress, anxiety, family violence, suicidality, and wellbeing in New Zealand during the COVID-19 lockdown: A cross-sectional study

Urbanicity, biological stress system functioning and mental health in adolescents

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