Download Centre for Emotional Health

Centre for Emotional Health Ageing Research
Viviana Wuthrich
Centre for Emotional Health
(CEH)
• Centre for research excellence
• Focused on the understanding, treatment and
prevention of anxiety, depression and related mental
health problems
• The Centre for Emotional Health also encompasses
the Emotional Health Clinic and the eCentreClinic
Current members & Output
• 11 Academic staff
• 6 Post-doctoral research fellows
• Around 65 doctoral students
• Total research funding > $8.5M. (2010 – 2014)
• Scientific publications > 115 (2010 – 2011)
Emotional Health Clinic
• Highly respected clinical treatment service that provides
the latest help for people suffering emotional difficulties.
• Provides treatment and assessment services to around
500+ clients per year
• Strong reputation among public and professionals
• Around 30 students & 10 professional visitors each year
Agenda
• Prevalence of anxiety and depression
• Common signs of anxiety and depression in older
adults
• Consequence of these problems being left untreated
• Latest findings regarding treatment of these problems
in older adults
Ageing Population
• ABS estimations for over 65 year olds:
– 2004 = 13% (or 2.6 million)
– 2051 = 26%
• Estimation for over 85 year olds:
– 2007 = 1.6%
– 2051 = 5-7%
Mental Health Research is
Neglected in Older Adults
• Apart from Dementia
• Little research exists into the understanding and
treatment of anxiety and depression in older adults
• There is more research for depression, very few
studies focus on anxiety in older adults
Prevalence of Anxiety &
Depression in Adults over 60
• Prevalence of clinical anxiety disorders is up to
10.2%
• 24% for clinical depression in adults
• Rates of clinical disorders for anxiety and depression
decrease in older adulthood
12 month prevalence of anxiety and
depression by age group (NSMHW, 2007)
Lower Prevalence Rates
• Prevalence may be underestimated:
– Tools used to measure are unsuitable
– Older adults less willing to admit symptoms
– Symptoms change as people age
• Better coping skills -wisdom and life experience
Prevalence of Mild Anxiety &
Depression
• Rates of subclinical depression are as high as 25% in
primary health care settings, 50% in nursing homes
• Rates of subclinical anxiety up to 5-30%
Consequences of Untreated
Symptoms
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Life dissatisfaction
Disability
Mortality
Medication
Health care services
Suicide
Dementia
Completed Suicide (ABS, 2010)
Symptoms of Depression
• Sadness, tearfulness – but this is less prominent than
in younger samples
• Loss of interest
• Low motivation
• Hopelessness
• Excessive fatigue
• Difficulty sleeping
Reduced Levels of Sadness
• Unclear why this is. Hypotheses include:
– Less willing to admit low mood
– Less able to recognise it
– Depression characterised by hopelessness and
helplessness rather than sadness
– Biological changes or vascular lesions might result
in differences in symptoms presentation
Symptoms of Anxiety
• Anxiety most characterised by worry
– Worry about relationships, health, finances, family
– Restlessness or agitation
– Difficulty sleeping
• Other anxiety is less common (post traumatic stress,
social anxiety, obsessive compulsive disorder)
Common Themes of Distress
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Life long anxiety and/or depression
Relationship conflict
Worry about family, children and grandchildren
Burden of caring for frail parents or spouse
Worry: ageing, illness, dementia, fitness, finances
Difficulty adjusting to retirement, loss of purpose
Bereavement
Isolation, loss of social networks
Help Seeking- NSMHW (2007)
• Of those people who identified as having anxiety or
depression, service use was lowest among the young
people (23%) and older adults aged 75-85years
(23%)
• Males were particularly unlikely to seek help across
all age groups
Treatment for Anxiety & Depression
• Most common treatments are medications
– Possible side-effects, drug-to-drug interactions
• Psychological treatments are also effective
– International research indicates that psychological
techniques can greatly benefit older adults
– Problem solving skills, relaxation, changing
negative thinking, socialising and discussion
groups are all helpful
Treatment continued
• Research normally is targeted at anxiety OR
depression
• Anxiety and depression commonly co-occur
throughout the lifespan
– Community sample in Netherlands aged 55-85 yrs
comorbid prevalence of major depression and any
anxiety disorder was 47.5%
• Some research indicates that having both reduces
the effectiveness of treating the other disorder
Our Research
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Assessment of anxiety and depression in older adults
Symptom profiles
Emotion regulation
Coping skills
Barriers to treatment seeking
Psychological Treatments
Impact of cognitive changes on effectiveness of
psychological treatments
Recent Trial (2007-2010)
• Developed and examined the effectiveness of a
group psychological treatment for comorbid anxiety
and depression in adults over 60
• Compared to doing nothing, we found that
psychological treatment provided benefits for both
anxiety and depression symptoms and improved
quality of life
• These improvements were lasting (evident 3 months
later)
Changes in Depression Score
Latest Research
• Comparing two different psychological treatments to
determine which is the most effective (randomised
controlled trial)
• Comorbid anxiety and depression in older adults
aged 60 and over
• Examining changes in symptom severity, quality of
life, and cognitive performance
• 3 year trial funded by National Health & Medical
Research Council (2011-2013)
Contact Details
• Further information about the free group treatment
program for treating anxiety and depression in adults
over 60 is available by contacting the Emotional
Health Clinic on 9850 -8711
• Information on the Centre for Emotional Health is
available at www.centreforemotionalhealth.com.au