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

Thompson, Katherine N., Hübel, Christopher, Cheesman, Rosa, Adey, Brett N., Armour, Chérie, Davies, Molly R., Hotopf, Matthew, Jones, Ian R. ORCID:, Kalsi, Gursharan, McIntosh, Andrew M., Monssen, Dina, Peel, Alicia J., Rogers, Henry C., Skelton, Megan, Smith, Daniel J., Walters, James T. R. ORCID:, Breen, Gerome and Eley, Thalia C. 2021. Age and sex-related variability in the presentation of generalized anxiety and depression symptoms. Depression and Anxiety 38 (10) , pp. 1054-1065. 10.1002/da.23213

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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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Additional Information: This is an open access article under the terms of the Creative Commons Attribution License
Publisher: Wiley
ISSN: 1091-4269
Date of First Compliant Deposit: 17 May 2022
Date of Acceptance: 20 August 2021
Last Modified: 06 May 2023 21:00

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