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Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity

Published online by Cambridge University Press:  19 May 2008

K. M. Scott*
Department of Psychological Medicine, Otago University, Wellington, New Zealand
M. Von Korff
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA, USA
J. Alonso
Health Services Research Unit, Institute Municipal d'Investigacio Medica (IMIM), and CIBER en Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
M. Angermeyer
Center for Public Mental Health, Austria
E. J. Bromet
SUNY Stony Brook, Stony Brook, New York, USA
R. Bruffaerts
Department of Neurosciences and Psychiatry, University Hospital, Gasthuisberg, Leuven, Belgium
G. de Girolamo
Regional Health Care Agency, Emilia-Romagna Region, Bologna, Italy
R. de Graaf
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
A. Fernandez
Fundació Sant Joan de Déu Research and Development Unit, Barcelona, Spain
O. Gureje
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
Y. He
Shanghai Mental Health Center, Shanghai, People's Republic of China
R. C. Kessler
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
V. Kovess
Fondation MGEN Pour La Santé Publique, Université Paris 5, Paris, France
D. Levinson
Mental Health Services, Ministry of Health, Jerusalem, Israel
M. E. Medina-Mora
Department of Epidemiology, National Institute of Psychiatry, Mexico City, Mexico
Z. Mneimneh
Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
M. A. Oakley Browne
Department of Rural and Indigenous Health, School of Rural Health, Monash University, Victoria, Australia
J. Posada-Villa
Colegio Mayor de Cundinamarca University, Bogota, Colombia
H. Tachimori
National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
D. Williams
Department of Society, Human Development and Health, Harvard School of Public Health, Harvard University, Boston, MA, USA
*Address for correspondence: K. M Scott, Ph.D., Department of Psychological Medicine, Otago University, Wellington, PO Box 7343, Wellington South, New Zealand. (Email:



Physical morbidity is a potent risk factor for depression onset and clearly increases with age, yet prior research has often found depressive disorders to decrease with age. This study tests the possibility that the relationship between age and mental disorders differs as a function of physical co-morbidity.


Eighteen general population surveys were carried out among household-residing adults as part of the World Mental Health (WMH) surveys initiative (n=42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). The effect of age was estimated for 12-month depressive and/or anxiety disorders with and without physical or pain co-morbidity, and for physical and/or pain conditions without mental co-morbidity.


Depressive and anxiety disorders decreased with age, a result that cannot be explained by organic exclusion criteria. No significant difference was found in the relationship between mental disorders and age as a function of physical/pain co-morbidity. The majority of older persons have chronic physical or pain conditions without co-morbid mental disorders; by contrast, the majority of those with mental disorders have physical/pain co-morbidity, particularly among the older age groups.


CIDI-diagnosed depressive and anxiety disorders in the general population decrease with age, despite greatly increasing physical morbidity with age. Physical morbidity among persons with mental disorder is the norm, particularly in older populations. Health professionals, including mental health professionals, need to address barriers to the management of physical co-morbidity among those with mental disorders.

Original Articles
Copyright © 2008 Cambridge University Press

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