Objective: To examine the association of depression and/or anxiety symptoms with psychopathology.
Method: As part of the UPBEAT (Unified Psychogeriatric Biopsychosocial Evaluation and Treatment) Program elderly, hospitalized medical and surgical veterans without recent psychiatric diagnoses were screened for symptoms of depression and anxiety using the Mental Health Inventory (MHI). Following discharge, we evaluated these patients diagnostically for psychopathology using DSM Axis 1 criteria. Here we report on those 839 UPBEAT care patients who met screening cut-offs for depression and/or anxiety symptoms and had data available for DSM Axis 1 diagnoses. These patients were mostly male veterans (96.3%) and had a mean age of 69.6±6.7 years (range, 60-91). We compared three groups for the presence of any Axis I disorder, as well as separately for the presence of mood, anxiety, adjustment or “other” disorders. The three groups were those meeting screening criteria or symptoms of (i) both depression and anxiety (n=464, 55.3%) (ii) depression only (n=273, 32.5%) symptoms, and (iii) anxiety only (n=102, 12.2%)
Results: We found that 58.6% of the UPBEAT Care patients received a DSM IV Axis 1 diagnosis at the time of in-depth psychiatric evaluation, despite absence of recent psychiatric history. The distribution was as follows: 7.5% mood; 15.4% anxiety; 21.8% adjustment, and 14 % other disorders. A significantly greater percentage of patients meeting screening criteria for symptoms of both depression and anxiety had a subsequent DSM IV Axis 1 diagnosis of any type when compared to those who screened in for anxiety symptoms alone (61.9% vs.49.0%). A significantly greater percentage of patients meeting screening criteria for symptoms of both depression and anxiety received a subsequent diagnosis of mood disorder than did those meeting screening criteria for symptoms of depression alone (10.1% vs. 5.5%).
Conclusion: If the results are confirmed, screening the types of patients described above for symptoms of depression, anxiety, and, in particular, for the combination of the two, may help identify those with previously undetected DSM IV Axis 1 diagnosis, including adjustment disorders.
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