Prevalence and correlates of anxiety disorders and depressive disorders among older adults with non-communicable diseases: results from China Mental Health survey

Hongmin Ge^1,2Zhaorui Liu^3,4,5,6Yue Tong^1,2Yueqin Huang^3,4,5,6Xiaofei Hou^1,2Minghui Li^1,2Yongping Yan⁷Shuiyuan Xiao⁸Lingjiang Li⁹Tingting Zhang^10,3,4,5Jie Yan¹¹Yaqin Yu¹²Xiufeng Xu¹³Zhizhong Wang¹⁴Yifeng Xu¹⁵Tao Li¹⁶Xiangdong Xu¹⁷Limin Wang¹⁸Huifang Yin^1,2*Guangming Xu^1,2*

• ¹Tianjin Anding Hospital, Tianjin, China
• ²Mental Health Center of Tianjin Medical University, Tianjin, China
• ³Peking University Sixth Hospital, Beijing, China
• ⁴Peking University Institute of Mental Health, Beijing, China
• ⁵NHC Key Laboratory of Mental Health (Peking University), Beijing, China
• ⁶National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
• ⁷Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China
• ⁸Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
• ⁹Mental Health Institute, the Second Xiangya Hospital, Central-south University, Changsha, China
• ¹⁰National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital),, Beijing, China
• ¹¹Institute of Social Science Survey, Peking University,, Beijing, China
• ¹²Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
• ¹³Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
• ¹⁴Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
• ¹⁵Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ¹⁶Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
• ¹⁷The Fourth People's Hospital in Urumqi, Urumqi, China
• ¹⁸National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

Background: Anxiety disorders (ADs) and depressive disorders (DDs) are prevalent among older adults with non-communicable diseases (NCDs), yet nationally representative epidemiological data from China remain limited. This study, as a part of the 2013-2015 China Mental Health Survey (CMHS), aimed to assess the prevalence of ADs and DDs and identify associated factors among older adults with NCDs in China.Method: A total of 5,428 patients aged 60 years and above with reported NCDs were selected from the CMHS. The Composite International Diagnostic Interview (CIDI) was used to diagnose ADs, DDs, and alcohol use disorders (AUDs) in order to assess their disease status and the lifetime and 12month prevalence. Data were weighted by age, sex, and residential distribution from the 2010 Chinese census to correct for selection probabilities and response rates, and were post-stratified for national representativeness. Univariate and multivariate logistic regression was used to identify factors associated with 12-month ADs and DDs.The lifetime prevalence of ADs was 8.3% and the 12-month prevalence of ADs was 5.8%.The two most prevalent ADs were specific phobia (SP; lifetime prevalence of 4.2% and 12-month prevalence of 3.1%) and obsessive-compulsive disorder (OCD; lifetime prevalence of 2.8% and 12month prevalence of 2.1%). The lifetime prevalence of DDs was 10.1%, while the 12-month prevalence was 5.4%. The two most common DDs were major depressive disorder (MDD; lifetime prevalence of 7.2% and 12-month prevalence of 4.4%) and dysthymia (lifetime prevalence of 2.8% and 12-month prevalence of 2.2%). ADs are most common in individuals with heart attacks (12%), chronic lung disease (11.2%), and other chronic pain (11%). DDs are most commonly linked to heart attacks (13.8%), other chronic pain (13.2%), and cancer (13.1%). Female gender, alcohol use disorder, and comorbid with three or more NCDs were found to be risk factors associated with ADs and DDs.The co-occurrence of mental disorders among older adults with NCDs has become a growing public health concern in China. Primary health care institutions and clinicians should simultaneously enhance the management of chronic NCDs and mental health care among older adults.