Why does the lifetime prevalence of major depressive disorder in the elderly appear to be lower than in younger adults? Results from a national representative sample

Hoertel, Nicolas; Strat, Yann Le; Gorwood, Philip; Béra-Potelle, Céline; Schuster, Jean-Pierre; Manetti, Aude; Dubertret, Caroline; Limosin, Frédéric

doi:10.1016/j.jad.2013.01.017

Cited by 26 publications

(17 citation statements)

References 31 publications

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“…However, all disorders (except for antisocial personality disorder) were assessed on a 12-month time frame, limiting those biases. In addition, the prevalence rates found in this study are consistent with those of prior studies (Donnellan and Lucas, 2008; Gum et al, 2009; Hasin et al, 2005; Hoertel et al, 2013; Jorm, 2000; Kessler et al 2005a; Manetti et al, 2013; Schuster et al 2013a; Seitz et al, 2010; Sunderland et al, 2014; Weissman et al, 1985), including studies conducted among institutionalized individuals. Secondly, the lifetime assessment of antisocial personality disorder may have favored the invariance across age groups.…”

Section: Discussionsupporting

confidence: 91%

“…While numerous previous studies have consistently demonstrated that psychiatric disorders are less common in the older population (Donnellan and Lucas, 2008; Gum et al, 2009; Hasin et al, 2005; Hoertel et al, 2013; Jorm, 2000; Kessler et al, 2005a; Manetti et al, 2013; Schuster et al, 2013a; Seitz et al, 2010; Sunderland et al, 2014; Weissman et al, 1985), our study demonstrates that the observed lower prevalence of mental disorders in this population originates from its decrease in average psychopathological load, as measured by lower scores on the internalizing and externalizing latent liability dimensions. Several factors may contribute to this decreased load.…”

Section: Discussioncontrasting

confidence: 54%

“…When examined independently, the prevalence rates of most common psychiatric disorders are substantially lower in older than in younger adults (Donnellan and Lucas, 2008; Gum et al, 2009; Hasin et al, 2005; Hoertel et al, 2013; Jorm, 2000; Kessler et al, 2005a; Manetti et al, 2013; Schuster et al, 2013a; Seitz et al, 2010; Sunderland et al, 2014; Weissman et al, 1985), which may affect the structure of comorbidity. Three previous studies (Buchan et al, 2014; Eaton et al, 2011; Sunderland et al, 2013) have suggested that the structure of comorbidity may hold in individuals as they age.…”

Section: Introductionmentioning

confidence: 99%

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A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

Hoertel

McMahon

Olfson

et al. 2015

Journal of Psychiatric Research

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Recent theories have proposed a metastructure that organizes related mental disorders into broad dimensions of psychopathology (i.e., internalizing and externalizing dimensions). Prevalence rates of most mental disorders, when examined independently, are substantially lower in older than in younger adults, which may affect this metastructure. Within a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093), we developed a dimensional liability model of common psychiatric disorders to clarify whether aging affects specific disorders or general dimensions of psychopathology. Significant age differences existed across age groups (18-24, 25-34, 35-44, 45-54, 55-64, 65-75 and 75+), such that older adults showed lower prevalence rates of most disorders compared to younger adults. We next investigated patterns of disorder comorbidity for past-year psychiatric disorders and found that a distress-fear-externalizing liability model fit the data well. This model was age-group invariant and indicated that that the observed lower prevalence of mental disorders with advancing age originates from lower average means on externalizing and internalizing liability dimensions. This unifying dimensional liability model of age and mental disorder comorbidity can help inform the role of aging on mental disorder prevalence for research and intervention efforts, and service planning for the impending crisis in geriatric mental health.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

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A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

Hoertel

McMahon

Olfson

et al. 2015

Journal of Psychiatric Research

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“…), mais également de l'impact des pathologies somatiques éventuelles [11] [12]. De surcroît, 9,8 % des sujets rapportaient des idéations suicidaires.…”

Section: Prévalence De La Dépression Chez Le Sujet âGéunclassified

Dépression du sujet âgé : données épidémiologiques, aspects cliniques et approches thérapeutiques spécifiques

Limosin

Manetti²,

René³

et al. 2015

NPG Neurologie - Psychiatrie - Gériatrie

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“…They include severity of major depression (Sargeant et al, 1990; Skodol et al, 2011; Spijker et al, 2010; Steinert et al, 2014), number of lifetime MDEs (Skodol et al, 2011; Spijker et al, 2010, Steinert et al, 2014), co-occurring Axis I (Hoertel et al, 2013a, 2013b, 2013c; Keller et al, 1982, 1992; Klein et al, 2006; Manetti et al, 2014; Steinert et al, 2014) and Axis II disorders (Grilo et al, 2005; Skodol et al, 2011), history of suicide attempts (Avery and Winokur, 1978), family history of depression (Patten et al, 2010), concurrent physical health problems and psychosocial difficulties (Lam et al, 2009), early age at onset of first MDE (Hoertel et al, 2013a; Klein et al, 1999), stressful live events (Wang et al, 2012), female gender, older age and being divorced or widowed (Colman et al, 2011; Dowrick et al, 2011; Fava et al, 2007; Gilman et al, 2013; Hardeveld et al, 2013a, 2013b; Kornstein et al, 2000; Lam et al, 2009; Patten et al, 2012; ten Doesschate et al, 2010; Wang et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

Hoertel

Blanco

Oquendo

et al. 2017

Journal of Psychiatric Research

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Identifying predictors of persistence and recurrence of depression in individuals with a major depressive episode (MDE) poses a critical challenge for clinicians and researchers. We develop using a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N=34,653), a comprehensive model of the 3-year risk of persistence and recurrence in individuals with MDE at baseline. We used structural equation modeling to examine simultaneously the effects of four broad groups of clinical factors on the risk of MDE persistence and recurrence: 1) severity of depressive illness, 2) severity of mental and physical comorbidity, 3) sociodemographic characteristics and 4) treatment-seeking behavior. Approximately 16% and 21% of the 2,587 participants with an MDE at baseline had a persistent MDE and a new MDE during the 3-year follow-up period, respectively. Most independent predictors were common for both persistence and recurrence and included markers for the severity of the depressive illness at baseline (as measured by higher levels on the general depressive symptom dimension, lower mental component summary scores, prior suicide attempts, younger age at onset of depression and greater number of MDEs), the severity of comorbidities (as measured by higher levels on dimensions of psychopathology and lower physical component summary scores) and a failure to seek treatment for MDE at baseline. This population-based model highlights strategies that may improve the course of MDE, including the need to develop interventions that target multiple psychiatric disorders and promotion of treatment seeking to increase access to timely mental health care.

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Why does the lifetime prevalence of major depressive disorder in the elderly appear to be lower than in younger adults? Results from a national representative sample

Cited by 26 publications

References 31 publications

A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

Dépression du sujet âgé : données épidémiologiques, aspects cliniques et approches thérapeutiques spécifiques

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

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