1. Anxiety in Late-Life Depression: Determinants of the Course of Anxiety and Complete Remission.
- Author
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van der Veen DC, Gulpers B, van Zelst W, Köhler S, Comijs HC, Schoevers RA, and Oude Voshaar RC
- Subjects
- Aged, Aged, 80 and over, Anxiety complications, Anxiety psychology, Anxiety Disorders complications, Anxiety Disorders psychology, Comorbidity, Female, Humans, Male, Middle Aged, Netherlands, Neuroticism, Prognosis, Self Report, Anxiety diagnosis, Anxiety therapy, Anxiety Disorders diagnosis, Anxiety Disorders therapy, Depressive Disorder, Major complications, Life Change Events, Personality, Remission Induction
- Abstract
Objective: Studies on the course of depression often ignore comorbid anxiety disorders or anxiety symptoms. We explored predictors of complete remission (no depression nor anxiety diagnoses at follow-up) and of the course of comorbid anxiety symptoms. We additionally tested the hypothesis that the course of anxiety disorders and symptoms in depressed patients is explained by negative life-events in the presence of high neuroticism or a low sense of mastery., Methods: An observational study of 270 patients (≥60 years) diagnosed with major depressive disorder and 2-year follow-up data, who participated in the Netherlands Study of Depression in Older persons (NESDO). Sociodemographic, somatic, psychiatric, and treatment variables were first explored as possible predictors. A multiple logistic regression analysis was used to examine their predictive value concerning complete remission. Subsequently, negative life-events, personality and their interaction were tested as potential predictors. Linear Mixed Models were used to assess whether the personality traits modified the effect of early and recent life-events, and time and their interactions on the course of the anxiety symptoms., Results: A total of 135 of 270 patients achieved complete remission. Depressed patients with a comorbid anxiety disorder at baseline less often achieved complete remission: 38 of 103 (37.0%) versus 97 of 167 (58.1%). The severity of depressive and anxiety symptomatology, the presence of a comorbid anxiety disorder, and a poorer physical health at baseline predicted nonremission. In line with our hypothesis, a less favorable course of self-reported anxiety symptoms was associated with more recent negative life-events, but only among patients with a high level of neuroticism or a low level of mastery., Conclusion: Comorbid anxiety in depression as a negative impact on complete remission at 2-year follow-up. The course of anxiety severity seems dependent on the interaction of personality traits and life-events., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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