Persistence and Remission of Psychiatric Disorders in the Quebec Older Adult Population

Abstract

Objective: To document the remission and persistence of psychiatric disorders in Quebec's older adult population. Method: Data came from the Enquěte sur la santé des aînés (ESA) study conducted in 2005–2008 using a representative sample ( n = 2784) of community-dwelling older adults. Results: The ESA study results indicate that 12% of respondents met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for depression, mania, anxiety disorders, or benzodiazepine drug dependency at the baseline interview. The results also indicate that the 12-month rate of patients with a persistent psychiatric condition was 19.4%. Sixty-seven percent of the patients in remission experienced a total recovery of their symptoms during the following year. The probability of presenting a persistent psychiatric condition or a partial remission after 1 year of follow-up, compared with those in total remission, did not vary according to sociodemographic characteristics. The results also showed that social support and the number of chronic health problems did not influence mental health at follow-up. However, results indicated that the use of health services (OR 7.4; 95% CI 3.72 to 14.55) and the change in the number of chronic health problems reported between baseline and the second interview (OR 1.2; 95% CI 1.06 to 1.34) increased the probability of patients with prevalent disorders at Time 1 having persistent disorders at Time 2. Conclusion: Results suggest that a deterioration of physical health status was associated with the persistence of DSM-IV disorders in the elderly. These results also suggest that the use of mental health services is associated with severity of the mental illness.