The Natural History of Neurotic Disorder in an Elderly Urban Population

Abstract

A random community sample of 1070 subjects aged 65 years and over was interviewed at home using the GMS-agecat package and followed up three years later. Neurotic symptoms were common, but symptoms sufficient to reach ‘case’ level were much less frequent. The overall prevalence of neurotic ‘cases' was 2.4% in year 0 and 1.4% in year 3. The incidence was estimated as a minimum of 4.4 per 1000 per year over the age of 65. Women were more likely to be ‘cases' than men but not ‘subcases', and there was a general decline in prevalence with increasing age, particularly for ‘subcases'. Anxiety was the commonest neurotic subtype. After three years, ‘cases' were shown not to persist, but this did not reflect wellness. There was a tendency still to have some symptoms, but the predominant symptom appeared to change, suggesting a possible chronic neurotic disorder with changing presentation over time. Depressive symptoms were closely associated with this presentation, suggesting that depression may be an important and integral part of a general, changing neurotic disorder.