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Anxiety in Late-Life Depression: Determinants of the Course of Anxiety and Complete Remission

•Building on previous cross-sectional findings, this study explores predictors of complete remission (no depression nor anxiety diagnoses at 2-year follow-up) and of the course of comorbid anxiety symptoms.•Depressed patients with a comorbid anxiety disorder at baseline less often achieved complete...

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Bibliographic Details
Published in:The American journal of geriatric psychiatry 2021-04, Vol.29 (4), p.336-347
Main Authors: van der Veen, Date C., Gulpers, Bernice, van Zelst, Willeke, Köhler, Sebastian, Comijs, Hannie C., Schoevers, Robert A., Oude Voshaar, Richard C.
Format: Article
Language:English
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Summary:•Building on previous cross-sectional findings, this study explores predictors of complete remission (no depression nor anxiety diagnoses at 2-year follow-up) and of the course of comorbid anxiety symptoms.•Depressed patients with a comorbid anxiety disorder at baseline less often achieved complete remission. The severity of depressive and anxiety symptomatology, the presence of a comorbid anxiety disorder, and a poorer physical health at baseline predicted non-remission.•In the face of negative life-events, maladaptive personality traits may play a central role in the prognosis of late-life depression due to its impact on anxiety.•Interventions to reduce depression and anxiety symptomology need to incorporate techniques that enhance aspect of psychological well-being, like the sense of mastery for daily life-stress continues to be a risk factor among non- or partly remitted older adults. 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. 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. 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 cou
ISSN:1064-7481
1545-7214
DOI:10.1016/j.jagp.2020.12.023