Age and sex‐related variability in the presentation of generalized anxiety and depression symptoms

Katherine N. Thompson, Christopher Hübel, Rosa Cheesman, Brett N. Adey, Chérie Armour, Molly R. Davies, Matthew Hotopf, Ian R. Jones, Gursharan Kalsi, Andrew M. McIntosh, Dina Monssen, Alicia J. Peel, Henry C. Rogers, Megan Skelton, Daniel J. Smith, James T. R. Walters, Gerome Breen, Thalia C. Eley

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Abstract

Background: Generalized anxiety and depression are extremely prevalent and debilitating. There is evidence for age and sex variability in symptoms of depression, but despite comorbidity it is unclear whether this extends to anxiety symptomatology. Studies using questionnaire sum scores typically fail to address this phenotypic complexity.
Method: We conducted exploratory and confirmatory factor analyses on Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) items to identify latent factors of anxiety and depression in participants from the Genetic Links to Anxiety and Depression Study (N = 35,637; 16–93 years). We assessed age- and sex-related variability in latent factors and individual symptoms using multiple logistic regression.
Results: Four factors of mood, worry, motor, and somatic symptoms were identified (comparative fit index [CFI] = 0.99, Tucker–Lewis Index [TLI] = 0.99, root mean square error of approximation [RMSEA] = 0.07, standardized root mean square residuals [SRMR] = 0.04). Symptoms of irritability (odds ratio [OR] = 0.81) were most strongly associated with younger age, and sleep change (OR = 1.14) with older age. Males were more likely to report mood and motor symptoms (p < .001) and females to report somatic symptoms (p < .001).
Conclusion: Significant age and sex variability suggest that classic diagnostic criteria reflect the presentation most commonly seen in younger males. This study provides avenues for diagnostic adaptation and factor-specific interventions.
Original languageEnglish
JournalDepression and Anxiety
Early online date08 Sep 2021
DOIs
Publication statusEarly online date - 08 Sep 2021

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