Depressive Symptom–Diagnosis Discordance in Later Life: National Prevalence and Correlates in the 2025 National Health Interview Survey
Year: 2026
Type: preprint
Abstract: This registration was submitted after completion of the statistical analyses and is intended to provide a time-stamped record of the study design, variables, hypotheses, and analytic workflow. It should not be interpreted as a prospective preregistration. This study conducted a cross-sectional secondary analysis of the 2025 National Health Interview Survey (NHIS) to examine depressive symptom–diagnosis discordance among U.S. adults aged 65 years and older. The primary objective was to estimate the nationally representative prevalence of symptom–diagnosis discordance among older adults with PHQ-8 scores ≥10, defined as clinically relevant current depressive symptoms without a self-reported previous professional diagnosis of depression. Prespecified substantive hypotheses examined associations with chronic pain, low in-person social connectivity, and cost-related unmet medical care. A secondary interaction analysis evaluated high-impact chronic pain × low social connectivity. Additional secondary analyses examined sociodemographic and clinical correlates, including age, sex, race/ethnicity, education, anxiety symptom burden, disability, and physical multimorbidity. Analyses incorporated the NHIS complex survey design, official sampling weights, and all 10 official income imputations.
Source: OSF Preprints (OSF Preprints)
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7208836890