RESULTS
The prevalence of depression in the original random sample of 1,070 community subjects was 11.3% overall (8.3% for depressive neurosis, 3.0% for depressive psychosis). Of the total sample, 2.7% reached case levels (diagnostic confidence level 3 and above) on both depression and anxiety clusters, or 24.0% of the depressive cases as a whole, or 70.7% of the anxious cases as a whole. Table 1 shows the percentage prevalence for subjects having coexistent levels of depression and anxiety after other diagnoses, e.g., organic states, schizophrenia,
hypochondriasis, obsessional and phobic states, had been excluded. Of the whole sample, 3.8% reached case level for anxiety and 32.2% reached subcase level; 11.7% of the total sample reached a subcase level of depression and of the 8.3% with depressive neurosis, 4.9% and 1.8% reached subcase and case levels of anxiety, whereas, of the 3.0% with depressive psychosis, 1.9% and 0.9%, respectively, reached subcase and case levels of anxiety. Thus, although the association of depressive levels with anxiety levels was common, 83.5% of cases of depression were associated with some levels of anxiety; those with coexistent case levels of both depression and anxiety seem to represent only a small proportion of elderly subjects. The outcome of the subjects in the study at this stage in the analysis is expressed crudely as dead, well (no confidence level on any diagnostic cluster), and psy-chiatrically ill (reached case level 3 and above on a diagnostic cluster). The first 80 subjects followed up after 3 years are reported. Ten of these 80 subjects with depressive case levels refused interview. The death rate of the subjects as a whole over the three years was 18%, or 6% per year, but was higher for the depressive sample at 27.1% or 9% per year. In order to compare outcome on these three indices the sample was split in a number of ways. The sample was separated into those depressive cases that had no anxiety confidence levels (14) and those depressive cases that had some anxiety levels (56) (Table 2). Although there is a tendency for a higher proportion of those subjects with depressive case levels and anxiety levels to be well at the end of three years, the differences do not reach statistical significance. The subjects were divided into those depressive cases with no AGECAT anxiety levels taken together with those scoring level 1 (19), against those scoring AGECAT anxiety levels 2 to 5 (51). Those depressive
cases with no AGECAT anxiety levels were taken together with those having subcase levels only were (55), against those cases which were also cases of anxiety (15). No trend emerged and none of the three methods for splitting the sample of depressed cases produced statistically significant differences. It may be of interest to note that only 3 of the 80 depressed cases received antidepressant medication (4%), 23% received hypnotics for sleep, and 10% received other sedatives, mainly benzodiazepines. This could not have been because these subjects were unknown to their general practitioners, because 86% of the depressive cases were receiving medication of some kind for physical illness.