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Impact of Symptoms of Generalized Anxiety Disorder on the Course of Late-Life Depression

Received December 11, 2003; revised March 15, April 16, 2004; accepted May 18, 2004. From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Send correspondence and reprint requests to David C. Steffens, M.D., M.H.S., Associate Professor of Psychiatry and Medicine, Head, Division of Geriatric Psychiatry, Duke University Medical Center, Box 3903, Durham, NC 27710. e-mail: steff001{at}mc.duke.edu
© 2005 American Association for Geriatric Psychiatry

Objective: The authors sought to examine the effect of symptoms of generalized anxiety disorder (GAD) on acute course of depression in a group of older depressed patients. Methods: Authors assessed GAD symptoms in a sample of 204 patients age 60 and older with unipolar major depression. Patients were treated naturalistically by study geriatric psychiatrists using a treatment guideline for geriatric depression and assessed with the Montgomery-Asberg Depression Rating Scale. They were dichotomized as meeting or not meeting GAD symptom criteria. The groups were analyzed by Cox proportional-hazards models. Results: There were 138 remitters and 66 non-remitters. After analysis controlled for benzodiazepine use, stressful life events, social support, and functional status, having GAD symptoms was associated with longer time-to-remission. Conclusions: Older depressed patients with GAD have a worse outcome than those without anxiety. Future studies will need to determine the appropriate role of benzodiazepines and other anxiolytics in the treatment of older depressed patients with symptoms of GAD.

Key Words: Anxiety Disorders • Depression • Comorbidity

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