Subsyndromal depression and anxiety predictors, consequences and two year outcome in the Irish elderly

Abstract

Depression is the commonest mental illness in late life and frequently occurs co- morbidly with anxiety. While all levels of illness severity have been reported a significant proportion of older adults suffer with clinically significant symptoms which fall outside diagnostic criteria for ‘caseness’. These subsyndromal mental disorders are gaining importance not only because they are more commonly observed than ‘case-level’ illness but also because they have a significant negative impact on morbidity, mortality and quality of life in this population. Furthermore the literature suggests that subsyndromal depression and anxiety may share similar risk factors and lie on a continuum with case-level depressive illness. The main objective of this thesis was to examine the impact (in terms of service use), course and clinical significance (in terms of two-year outcome) of subsyndromal anxiety and depression in the Irish community dwelling elderly. A secondary objective was to identify risk factors for depression in late life using a longitudinal study design.