Anxiety and somatic symptoms among elderly patients with depression.

This study aimed to evaluate the symptom profile, including anxiety and somatic symptoms among elderly patients with depression using the Geriatric depression scale (GDS-30), Beck Depression Inventory (BDI), Generalized anxiety Disorder -7 Scale (GAD-7) and Patient Health Questionnaire-15 (PHQ-15) scale. Additional aim was to carry out the factor analysis of symptoms reported on various scales. 83 elderly patients (age ≥60 years) with depression were evaluated on GDS-30, BDI, GAD-7 and PHQ-15. 60 subjects (72.28%) had GAD-7 score of ≥10, which is indicative of significant anxiety. On PHQ-15, 98.8% of patients had moderate to severe somatization. There was no correlation between severity of depressive symptoms (as assessed by GDS-30 and BDI) with anxiety and depressive symptoms except for significant correlation between BDI total score and GAD-7 total score (Pearson correlation coefficient-0.319;p = 0.003).Factor analysis of GDS-30 yielded a five factor solution and when the items of other 3 scales were added, the number of factors/symptoms clusters increased to 7. The present study suggests that there is a higher prevalence of anxiety and somatic symptoms in elderly patients with depression and GDS-30 is unable to capture all the symptoms of depression among elderly in the Indian context. Hence, complete assessment of depression in elderly should include assessment of anxiety and somatic symptoms by using other scales like GAD-7,BDI-II and PHQ-15. There is a need to develop a new scale which will be helpful in capturing the entire symptom profile of depression among elderly.

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