ABSTRACT
There is a need to validate screening measures of affective and generalized anxiety disorders for use in epidemiological surveys of mental health in the general population. This study examined the diagnostic accuracy of the Patient Health Questionnaire (PHQ-9), Goldberg Anxiety and Depression Scales (GAS, GDS) and the 12-item Short Form Health Survey (SF-12) Mental Health Component Summary Scale (MCS-12) in a population based longitudinal study in Australia. We report analyses of two narrow age birth cohorts in the Personality and Total Health (PATH) through life study (ages 32-36 and 52-58). Depressive episodes (severe, moderate, and mild), dysthymia and generalized anxiety disorder were diagnosed according to International Classification of Diseases (ICD-10) criteria using the World Health Organisation (WHO) Composite International Diagnostic Interview (CIDI) as a criterion. All scales had high concordance with their target 30-day diagnoses, with area under the Receiver Operating Characteristic (ROC) curve (AUC) ranging between 0.85 and 0.90. The PHQ-9, GDS, GAS and MCS-12 were all valid instruments for identifying possible cases of depression and anxiety, and assessing the severity of these common mental disorders in the general population. We report recommended cut-points for each scale, though note that the optimal cut-point on mental health screening instruments may vary depending on the context of test administration.
Subject(s)
Anxiety Disorders/diagnosis , Depressive Disorder/diagnosis , Epidemiologic Studies , Psychiatric Status Rating Scales/standards , Adult , Anxiety Disorders/epidemiology , Australia , Depressive Disorder/epidemiology , Female , Humans , Longitudinal Studies , Male , Middle AgedABSTRACT
BACKGROUND: Smoking, sedentary lifestyle and obesity are risk factors for mortality and dementia. However, their impact on cognitive impairment-free life expectancy (CIFLE)has not previously been estimated. METHODS: Data were drawn from the DYNOPTA dataset which was derived by harmonizing and pooling common measures from five longitudinal ageing studies. Participants for whom the Mini-Mental State Examination was available were included (N»8111,48.6% men). Data on education, sex, body mass index, smoking and sedentary lifestyle were collected and mortality data were obtained from Government Records via data linkage.Total life expectancy (LE), CIFLE and years spent with cognitive impairment (CILE)were estimated for each risk factor and total burden of risk factors. RESULTS: CILE was approximately 2 years for men and 3 years for women, regardless of age. For men and women respectively, reduced LE associated with smoking was 3.82and 5.88 years, associated with obesity was 0.62 and 1.72 years and associated with being sedentary was 2.50 and 2.89 years. Absence of each risk factor was associated with longer LE and CIFLE, but also longer CILE for smoking in women and being sedentary in both sexes. Compared with participants with no risk factors, those with 2þ had shorter CIFLE of up to 3.5 years depending on gender and education level. CONCLUSIONS: Population level reductions in smoking, sedentary lifestyle and obesity increase longevity and number of years lived without cognitive impairment. Years lived with cognitive impairment may also increase.
