Mediation model of comorbid anxiety disorders in late-life depression

Chawisa Suradom,Unchulee Taemeeyapradit,Suwanna Arunpongpaisal,Peerasak Lerttrakarnnon,Surin Jiraniramai,Nahathai Wongpakaran,Tinakon Wongpakaran,Surang Lertkachatarn,Pimolpun Kuntawong

doi:10.1186/s12991-020-00313-3

Abstract

BackgroundA number of studies have been conducted on risk factors of comorbid anxiety disorders regarding late-life depression (LLD). This study investigated the associated factors and their relationship to comorbid anxiety disorders in LLD.MethodsParticipants included 190 elderly Thais (73.2% female, with a mean age of 68.39 ± 6.74 years) with depressive disorders, diagnosed according to DSM-IV Diagnosis Axis I disorders assessed by Mini-International Neuropsychiatric Interview. Demographic data, medical and psychiatric history, family psychiatric history, past depression, family history of depression, Neuroticism Inventory and 7-Item Hamilton Depression Rating Scale (HAMD-7) were analyzed for path analysis using Structural Equation Model framework. The bootstrapping method was used for testing indirect effects.ResultsBeing female was associated with comorbid anxiety disorders with an indirect effect (β = − 0.032, P = 0.018) through neuroticism, depression severity, history and family history of depression. Family history of depression had no effect on comorbidity (P = 0.090). Neuroticism had an indirect effect on comorbid anxiety disorders (β = 0.075, P = 0.019) via depression severity as reflected by HAMD-7 score (β = 0.412, P = < 0.001). Total variance explained from this model was 11%. This model had good-fit index with Chi-square > 0.05, CFI and TLI > 0.95 and RMSEA < 0.06.ConclusionNeuroticism mediates the effect of relationship between sex, family history and history of depressive disorders and comorbid anxiety disorders in LLD. Moreover, depression severity is a mediator for neuroticism and comorbid anxiety disorders. Longitudinal studies are warranted to indicate the importance of effective treatment of depression to lower the risk of developing comorbid anxiety disorders among depressed elderly.

Highlights

A number of studies have been conducted on risk factors of comorbid anxiety disorders regarding late-life depression (LLD)
Depressive disorder correlated with neuroticism, comorbid anxiety disorders and depression severity
Comorbid anxiety disorders significantly correlated with family history of depressive disorder

Summary

Introduction

A number of studies have been conducted on risk factors of comorbid anxiety disorders regarding late-life depression (LLD). Anxiety is common in late-life depression (LLD), both as a symptom and as a comorbid disorder [1]. Comorbid anxiety disorders have been found to increase the burden of depression as reflected by quality of life, physical disability, increased health care use and mortality [2]. Comorbid anxiety disorder was associated with poorer social function, a higher level of somatic symptoms, a higher level of suicidality [1], a higher risk for alcohol abuse [3], disability [4] and lower cognitive performance [5]. A number of studies have been conducted on risk factors of comorbid anxiety disorders regarding LLD. Past depressive disorders increased the odds of repeated anxiety disorders, depressive disorders

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