노인에서 우울장애와 불안장애 동반질환인가, 증상인가?

Comorbid Anxiety in Elderly Patients with Depression

The frequent comorbidity of anxiety and depression, particularly among elderly, is widely recognized by clinicians, but the debate continues as to whether the combined diagnostic designation is merited. There remains a group of patients with depression and anxiety symptoms who are not well classifyed. This article reviews the debate over anxious depression, generalized anxiety disroder in patients with major depressive disorder, mixed anxiety-depressive disorder, and reviews anxiety symptoms in elderly patients with depression. Comorbid anxiety symptoms are associated with a more severe presentation of depressive illness, including greater suicidality. Most antidepressant treatment studies in the elderly have found poorer treatment outcomes in those with comorbid anxiety (including delayed or diminished response and increased likelihood of dropout from treatment). Since comorbid anxiety affect clincal course and prognosis, and may worsen long-term disability in late life depression, considerably more research in this field is needed.