Recognizing and treating late-life generalized anxiety disorder: distinguishing features and psychosocial treatment

References

• Kessler RC, DuPont RL, Berglund P, Wittchen H. Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. Am. J. Psychiat.156, 1915–1923 (1999).
   PubMed Web of Science ®Google Scholar
• Mogotsi M, Kaminer D, Stein DJ. Quality of life in the anxiety disorders. Harvard Rev. Psychiat.8, 273–282 (2000).
   PubMed Web of Science ®Google Scholar
• Beekman A, deBeurs E, vanBalkom AJLM, Deeg DJH, vanDyck R, vanTilburg W. Anxiety and depression in later life: co-occurrence and communality of risk factors. Am. J. Psychiat.157(1), 89–95 (2000).
   PubMed Web of Science ®Google Scholar
• Regier DA, Boyd JH, Burke JD, Rae DS, Myers JK, Kramer M. One-month prevalence of mental disorders in the United States: based on five epidemiologic catchment area sites. Arch. Gen. Psychiatry45, 977–986 (1988).
   PubMed Web of Science ®Google Scholar
• DeBeurs E, Beekman ATF, van Balkom AJLM, Deeg DJH, van Dyck R, van Tilburg W. Consequences of anxiety in older persons: its effect on disability, well being, and use of health services. Psychol. Med.29, 583–593 (1999).
   PubMed Web of Science ®Google Scholar
• Diefenbach GJ, Stanley MA, Beck JG. Worry content reported by older adults with and without generalized anxiety disorder. Aging Ment. Health5, 269–274 (2003).
   Web of Science ®Google Scholar
• Jones GN, Ames SC, Jeffries SK, Scarinci IC, Brantley PJ. Utilization of medical services and quality of life among low-income patients with generalized anxiety disorder attending primary care clinics. Int. J. Psychiat. Med.31(2), 183–198 (2001).
   PubMed Web of Science ®Google Scholar
• Kim HF, Kunik ME, Molinari V et al. Functional impairment in COPD patients: the impact of anxiety and depression. Psychosomatics41, 465–471 (2000).
   PubMed Web of Science ®Google Scholar
• Wittchen H, Kessler RC, Beesdo K, Krause P, Hofler M, Hoyer J. Generalized anxiety and depression in primary care: prevalence, recognition, and management.J. Clin. Psychiat.63, 24–34 (2002).
   PubMed Web of Science ®Google Scholar
• Beekman AT, Bremmer MA, Deeg DJ et al. Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. Int. J. Geriatr. Psych.13, 717–726 (1998).
   PubMed Web of Science ®Google Scholar
• Flint A. Epidemiology and comorbidity of anxiety disorders in the elderly. Am. J. Psychiat.151, 640–649 (1994).
   PubMed Web of Science ®Google Scholar
• Flint A. Anxiety disorders in late-life. Can. Fam. Physician45, 2672–2679 (1999).
   PubMed Web of Science ®Google Scholar
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders – Text Revision (4th Edition).APA, Washington DC, USA (2001).
   Google Scholar
• Gorenstein EE, Papp LA, Kleber MS, Mohlman J, deJesus M, Gorman JM. Cognitive-behavioral therapy for management of anxiety and medication taper in older adults. Am. J. Geriatr. Psych.13(10), 901–909 (2005).
   PubMed Web of Science ®Google Scholar
• Mohlman J, Gorenstein EE, Kleber MS, de Jesus M, Gorman JM, Papp LA. Standard and enhanced cognitive behavior therapy for late-life generalized anxiety disorder: two pilot investigations. Am. J. Geriatr. Psych.11, 24–32 (2003).
   PubMed Web of Science ®Google Scholar
• Mohlman J, Gorman JM. The role of executive functioning in CBT: a pilot study with anxious older adults. Behav. Res. Ther.43, 447–465 (2005).
   PubMed Web of Science ®Google Scholar
• Stanley MA, Beck JG, Novy DM et al. Cognitive behavioral treatment of late-life generalized anxiety disorder. J. Consult. Clin. Psych.71, 309–319 (2003).
   PubMed Web of Science ®Google Scholar
• Wetherell JL, Gatz M, Craske MG. Treatment of generalized anxiety disorder in older adults. J. Consult. Clin. Psych.71, 31–40 (2003).
   PubMed Web of Science ®Google Scholar
• Blazer D, George LK, Hughes D. The epidemiology of anxiety disorders: an age comparison. In: Anxiety in the Elderly. Salzman C, Lebowitz BD (Eds). Springer, NY, USA, 17–30 (1991).
   Google Scholar
• Barlow DH, Lerner J, Esler J. Behavioral health care in primary care settings: recognition and treatment of anxiety disorders. In: Health Psychology Throughout the Lifespan: Practice and Research opportunities. Resnick RJ, Rozensky RH (Eds). American Psychological Association, WA, USA, 133–148 (1996).
   Google Scholar
• Akkerman R, Stanley M, Averill P, Novy D, Snyder AG, Diefenbach GJ. Recruiting older adults with generalized anxiety disorder. J. Ment. Health Aging7, 385–394 (2002).
   Google Scholar
• Stanley MA, Roberts RE, Bourland SL, Novy DM. Anxiety disorders among older primary care patients. J. Clin. Geropsych.7, 105–116 (2001).
   Google Scholar
• Ettner SL, Hermann RC. Provider specialty choice among Medicare beneficiaries treated for psychiatric disorders. Health Care Fin. Rev.18, 43–59 (1997).
   PubMedGoogle Scholar
• Gould RA, Safren SA, Washington DO, Otto MW. A meta-analytic review of cognitive-behavioral treatments. In: Generalized Anxiety Disorder: Advances in Research and Practice. Heimberg RG, Turk CL, Mennin DS (Eds). Guilford Press, NY, USA, 248–264 (2004).
   Google Scholar
• Beck JG, Stanley MA, Zebb BJ. Characteristics of generalized anxiety disorder in older adults: a descriptive study. Behav. Res. Ther.34, 225–234 (1996).
   PubMed Web of Science ®Google Scholar
• Mohlman J. Psychosocial treatment of late-life generalized anxiety disorder: current status and future directions. Clin. Psychol. Rev.24, 149–169 (2004).
   PubMed Web of Science ®Google Scholar
• Kogan JN, Edelstein BA, McKee DR. Assessment of anxiety in older adults: current status. J. Anxiety Disord.14, 109–132 (2000).
   PubMed Web of Science ®Google Scholar
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders – Text Revision (3rd Edition). APA, WA, USA (1987).
   Google Scholar
• DiNardo PA, Brown TA, Barlow DH. Anxiety Disorders Interview Schedule for DSM-IV. Center for Stress and Anxiety Related Disorders, Boston University, MA, USA (1994).
   Google Scholar
• Roemer L, Molina S, Borkovec TD. An investigation of worry content among generally anxious individuals. J. Nerv. Ment. Dis.185, 314–319 (1997).
   PubMed Web of Science ®Google Scholar
• Doucet C, Ladouceur R, Freeston MH, Dugas MJ. Worry themes and the tendency to worry in older adults. Can. J. Aging17, 361–371 (1998).
   Web of Science ®Google Scholar
• Skarborn M, Nicki R. Worry in pre- and post-retirement persons. Int. J. Aging Hum. Dev.50, 61–71 (2000).
   PubMed Web of Science ®Google Scholar
• Wisocki PA. The experience of worry among the elderly. In: Perspectives on Theory, Assessment, and Treatment. Davey GCL, Tallis F (Eds). Wiley & Sons, Oxford, UK, 247–261 (1994).
   Google Scholar
• Babcock RL, Laguna LB, Laguna KD, Urusky DA. Age differences in the experience of worry. J. Ment. Health Aging6, 227–234 (2000).
   Google Scholar
• Cappeliez P. Daily worries and coping strategies: implications for therapists. Clin. Geront.8, 70–71 (1989).
   Google Scholar
• Wisocki PA, Handen B, Morse C. The Worry Scale as a measure of anxiety among homebound and community active elderly. Behav. Therapist9, 91–95 (1986).
   Google Scholar
• Hunt S, Wisocki P, Yanko J. Worry and use of coping strategies among older and younger adults. J. Anxiety Disord.17, 547–560 (2003).
   PubMed Web of Science ®Google Scholar
• Felton BJ, Revenson TA. Age differences in coping with chronic illness. Psychol. Aging2, 164–170 (1987).
   PubMed Web of Science ®Google Scholar
• Beck JG, Averill PM. Older adults. In: Generalized Anxiety Disorder. Heimberg RG, Turk CL, Mennin DS (Eds). The Guilford Press, NY, USA, 409–433 (2004).
   Google Scholar
• Lipton M, Schaffer W. Physical symptoms related to post-traumatic stress disorder (PTSD) in an aging population. Mil. Med.153, 316–318 (1998).
   Google Scholar
• Montorio I, Nuevo R, Marquez M, Izal M, Losada A. Characterization of worry according to severity of anxiety in elderly living in the community. Aging Ment. Health7, 334–341 (2003).
   PubMed Web of Science ®Google Scholar
• Wetherell JL, LeRoux H, Gatz M. DSM-IV criteria for generalized anxiety disorder in older adults: distinguishing the worried from the well. Psychol. Aging18, 622–627 (2003).
   PubMed Web of Science ®Google Scholar
• Hasher L, Zacks RT. Working memory, comprehension, and aging: a review and a new view. Psychol. Learn. Motiv.22, 193–225 (1988).
   Google Scholar
• Brown TA, Marten PA, Barlow DH. Discriminant validity of the symptoms constituting the DSM-III-R and DSM-IV associated symptom criterion of generalized anxiety disorder. J. Anxiety Disord.9, 317–328 (1995).
   Web of Science ®Google Scholar
• Joorman J, Stober J. Somatic symptoms of generalized anxiety disorder from the DSM-IV: associations with pathological worry and depression symptoms in a nonclinical sample. J. Anxiety Disord.13, 491–503 (1999).
   PubMed Web of Science ®Google Scholar
• Xavier FM, Ferraz MP, Trenti CM et al. Generalized anxiety disorder in a population aged 80 years and older. Rev. Saude Publ.35, 294–302 (2001).
   PubMed Web of Science ®Google Scholar
• Brawman-Mintzer O, Lydiard RB, Emmanuel N, Payeur R. Psychiatric comorbidity in patients with generalized anxiety disorder. Am. J. Psychiat.150, 1216–1218 (1993).
   PubMed Web of Science ®Google Scholar
• Brown TA, Barlow DH. Comorbidity among anxiety disorders: implications for treatment and DSM-IV. J. Consult. Clin. Psych.60, 835–844 (1992).
   PubMed Web of Science ®Google Scholar
• Brown TA, Barlow DH, Liebowitz MR. The empirical basis of generalized anxiety disorder. Am. J. Psychiat.151, 1272–1280 (1994).
   PubMed Web of Science ®Google Scholar
• Gorman JM. Comorbidity of depression and panic disorder. J. Clin. Psychiat.57, 34–41 (1996).
   PubMed Web of Science ®Google Scholar
• Roy-Byrne PP. Generalized anxiety disorder and mixed anxiety-depression: association with disability and health care utilization. J. Clin. Psychiat.57, 86–91 (1996).
   PubMed Web of Science ®Google Scholar
• Lenze EJ, Mulsant BH, Mohlman J et al. Generalized anxiety disorder in late-life. Am. J. Geriatr. Psych.13, 77–80 (2005).
   PubMed Web of Science ®Google Scholar
• Kessler RC, Berglund P, Dewit DJ, Ustun T, Wang PS, Wittchen H. Distinguishing generalized anxiety disorder from major depression: prevalence and impairment from current pure and comorbid disorders in the US and Ontario. Int. J. Meth. Psych. Res.11, 99–111 (1999).
   Google Scholar
• Wittchen H, Krause P, Hoyer J et al. Prevalence and correlates of generalized anxiety disorder in primary care. Fortschr. Med.119, 17–25 (2001).
   Google Scholar
• Schoevers RA, Van Tilburg W, Beekman A, Deeg D. Depression and generalized anxiety disorder: co-occurrence and longitudinal patterns in elderly patients. Am. J. Geriatr. Psych.13, 31–39 (2005).
   PubMed Web of Science ®Google Scholar
• Mogg K, Bradley BP. Attentional bias in generalized anxiety disorder versus depressive disorder. Cognitive Ther. Res.29, 29–45 (2005).
   Web of Science ®Google Scholar
• Zimmerman M, Chelminski I. Generalized anxiety disorder in patients with major depression: is DSM-IV’s hierarchy correct? Am. J. Psychiat.160, 504–512 (2003).
   PubMed Web of Science ®Google Scholar
• Noyes R. Comorbidity in generalized anxiety disorder. Psychiat. Clin. N. Am.24, 41–55 (2001).
   PubMed Web of Science ®Google Scholar
• Kendler KS, Walters EE, Neale RC, Kessler AC, Heath AC, Eaves LJ. The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. Arch. Gen. Psychiat.52, 374–378 (1995).
   PubMed Web of Science ®Google Scholar
• Flint AJ. Generalised anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drug Aging22(2), 101–114 (2005).
   PubMed Web of Science ®Google Scholar
• Katon W, Von Korff M, Lin E et al. Distressed high utilizers of medical care: diagnoses and treatment needs. Gen. Hosp. Psychiat.12, 355–362 (1990).
   PubMed Web of Science ®Google Scholar
• Diefenbach GJ, Robison JT, Tolin DF, Blank K. Late-life anxiety disorders among Puerto Rican primary care patients: impact on well-being, functioning, and service utilization. J. Anxiety Disord.18(6), 841–858 (2004).
   PubMed Web of Science ®Google Scholar
• Goldberg DP, Bridges K. Somatic presentations of psychiatric illness in primary care setting. J. Psychosom. Res.32(2), 137–144 (1988).
   PubMed Web of Science ®Google Scholar
• Sherbourne CD, Wells K, Sturm R. Measuring health outcomes for depression. Eval. Health Prof.20, 47–64 (1997).
   PubMed Web of Science ®Google Scholar
• Van Balkom AJ, Beekman AT, deBeurs E et al. Comorbidity of the anxiety disorders in a community-based older population in The Netherlands. Acta Psychiat. Scand.101, 37–45 (2000).
   PubMed Web of Science ®Google Scholar
• Wittchen H, Hoyer J. Generalized anxiety disorder: nature and course. J. Clin. Psychiat.62(Suppl. 11), 15–19 (2001).
   PubMed Web of Science ®Google Scholar
• Kennedy BL, Schwab JJ. Utilization of medical specialists by anxiety disorder patients. Psychosomatics38, 109–112 (1997).
   PubMed Web of Science ®Google Scholar
• LaVia MF, Workman EW, Lydiard RB. Subtype response to stress-induced immunodepression. Funct. Neurol.7, 19–22 (1992).
   Google Scholar
• Carter C, Maddock R. Chest pain in generalized anxiety disorder. Int. J. Psychiat. Med.22, 291–298 (1992).
   PubMed Web of Science ®Google Scholar
• Logue MB, Thomas AM, Barbee JG et al. Generalized anxiety disorder patients seek evaluation for cardiological symptoms at the same frequency as patients with panic disorder. J. Psychiat. Res.27, 55–59 (1993).
   PubMed Web of Science ®Google Scholar
• Wulsin LR, Arnold LM, Hillard JR. Axis I disorders in ER patients with atypical chest pain. Int. J. Psychiat. Med.21(1), 37–46 (1991).
   PubMed Web of Science ®Google Scholar
• Barbee JG, Todorov AA, Kuczmierczyk AR et al. Explained and unexplained medical symptoms in generalized anxiety and panic disorder: relationship to the somatoform disorders. Ann. Clin. Psych.9, 149–155 (1997).
   PubMedGoogle Scholar
• Maier W, Falkai P. The epidemiology of comorbidity between depression, anxiety disorders and somatic diseases. Int. Clin. Psychopharm.14(Suppl. 2), S1–S6 (1999).
   Web of Science ®Google Scholar
• Lloyd KR, Jenkins R, Mann A. Long-term outcome of patients with neurotic illness in general practice. Brit. Med. J.313, 26–28 (1996).
   PubMed Web of Science ®Google Scholar
• Kessler RC, Wittchen H. Patterns and correlates of generalized anxiety disorder in community samples.J. Clin. Psychiat.63(Suppl. 8), 4–10 (2002).
   PubMed Web of Science ®Google Scholar
• Ormel J, VonKorff M, Van den Brink W, Katon W. Depression, anxiety, and social disability show synchrony of change in primary care patients. Am. J. Public Health83, 385–390 (1993).
   PubMed Web of Science ®Google Scholar
• Zayfert C, Dums AR, Ferguson RJ, Hegel MT. Health functioning impairments associated with posttraumatic stress disorder, anxiety disorders, and depression. J. Nerv. Ment. Dis.190, 233–240 (2002).
   PubMed Web of Science ®Google Scholar
• McIntosh A, Cohen A, Turnbull N et al.Clinical Guidelines and Evidence Review for Panic Disorder and Generalized Anxiety Disorder. University of Sheffield/London: National Collaborating Centre for Primary Care, Sheffield, UK (2004).
   Google Scholar
• Klap R, Unroe KT, Unutzer J. Caring for mental illness in the United States: a focus on older adults. Am. J. Geriatr. Psych.11(5), 517–524 (2003).
   PubMed Web of Science ®Google Scholar
• Stanley MA, Beck JG, Glassco JD. Treatment of generalized anxiety in older adults: a preliminary comparison of cognitive–behavioral and supportive approaches. Behav. Ther.27, 565–581 (1996).
   Web of Science ®Google Scholar
• Ladouceur R, Leger E, Dugas M, Freeston MH. Cognitive–behavioral treatment of generalized anxiety disorder (GAD) for older adults. Int. Psychogeriatr.16(2), 195–207 (2004).
   PubMed Web of Science ®Google Scholar
• Stanley MA, Hopko D, Diefenbach GJ, Bourland SL, Rodriguez H, Wagener P. Cognitive behavior therapy for late-life generalized anxiety disorder in primary care: preliminary findings. Am. J. Geriatr. Psych.11, 92–96 (2003).
   PubMed Web of Science ®Google Scholar
• Barlow DH. Anxiety and its Disorders. Guilford, NY, USA (2004).
   Google Scholar
• Borkovec TD, Whisman MA. Psychosocial treatment for generalized anxiety disorder. In: Long-Term Treatments of Anxiety disorders. Mavissakalian MR, Prien RF (Eds). American Psychiatric Association, WA, USA, 171–199 (1996).
   Google Scholar
• Andrews G, Sanderson K, Slade T et al. Why does the burden of disease persist? B. World Health Organ.78, 446–454 (2000).
   PubMed Web of Science ®Google Scholar
• Woodman CL, Noyes R, Black DW, Schlosser S, Yagla SJ. A 6-year follow up study of generalized anxiety disorder and panic disorder. J. Nerv. Ment. Dis.197, 3–9 (1998).
   Google Scholar
• Wetherell JL, Unutzer J. Adherence to treatment for geriatric depression and anxiety. CNS Spectr.8, 48–59 (2003).
   PubMed Web of Science ®Google Scholar
• Nordhus IH, Pallesen S. Psychological treatment of late-life anxiety: an empirical review. J. Consult. Clin. Psych.71, 643–651 (2003).
   PubMed Web of Science ®Google Scholar
• Gould RA, Safren SA, Washington DO, Otto MW. A meta-analytic review of cognitive-behavioral treatments. In: Generalized Anxiety Disorder: Advances in Research and Practice. Heimberg RG, Turk CL, Mennin DS (Eds). Guilford Press, NY, USA, 248–264 (2004).
   Google Scholar
• Burgio LD, Burgio KL. Behavioral gerontology: applications of behavioral methods to the problems of older adults. J. Appl. Behav. Anal.19, 321–328 (1986).
   PubMed Web of Science ®Google Scholar
• Knight BG, Satre DD. Psychotherapy with older adults. Clin. Psychol. Sci. Pr.6, 188–203 (1999).
   Web of Science ®Google Scholar
• Craske MG, Barlow DH, O’Leary T. Mastery of Your Anxiety and Worry. The Psychological Corporation, TX, USA (1992).
   Google Scholar
• Stanley MA, Averill P. Strategies for treating generalized anxiety disorder in the elderly. In: Handbook of Counseling and Psychotherapy with Older Adults. Duffy M (Ed.). Wiley, NY, USA, 511–525 (2000).
   Google Scholar
• Mohlman J, Mathew SJ, Kates W, AbdulSabur N. Executive functions and prefrontal cortex volume predict CBT outcome in late-life GAD. Presented at: The 34th Annual Meeting of the Anxiety Disorders Association of America. Seattle, WA, USA (2005).
   Google Scholar