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Age differences in trajectories of depressive, anxiety, and burnout symptoms in a population with a high likelihood of persistent occupational distress

Published online by Cambridge University Press:  28 September 2020

Celia F. Hybels*
Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
Dan G. Blazer
Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
David E. Eagle
Duke Global Health Institute, Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
Rae Jean Proeschold-Bell
Duke Global Health Institute, Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
Correspondence should be addressed to: Celia F. Hybels, PhD, Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3003, Durham, NC 27710, USA. Phone: +1 919 660 7546; Fax: +1 919 668 0453. Email:



Work in occupations with higher levels of occupational stress can bring mental health costs. Many older adults worldwide are continuing to work past traditional retirement age, raising the question whether older adults experience depression, anxiety, or burnout at the same or greater levels as younger workers, and whether there are differences by age in these levels over time.


Longitudinal survey of 1161 currently employed US clergy followed every 6–12 months for up to 66 months.


Depression was measured with the 8-item Patient Health Questionnaire (PHQ-8). Anxiety was measured using the anxiety component of the Hospital Anxiety and Depression Scale (HADS). Burnout symptoms were assessed using the three components of the Maslach Burnout Inventory: emotional exhaustion (EE), depersonalization (DP), and sense of personal accomplishment (PA).


Older participants had lower scores of depression, anxiety, EE, and DP and higher levels of PA over time compared to younger adults. Levels of EE decreased for older working adults, while not significantly changing over time for those younger. DP symptoms decreased over time among those 55 years or older but increased among those 25–54 years.


Older working adults may have higher levels of resilience and be able to balance personal life with their occupation as well as may engage in certain behaviors that increase social support and, for clergy, spiritual well-being that may decrease stress in a way that allows these older adults to appear to tolerate working longer without poorer mental health outcomes.

Original Research Article
© International Psychogeriatric Association 2020

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