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General mortality from anxiety and depression (the HUNT study)

Published online by Cambridge University Press:  16 April 2020

A. Mykletun
Affiliation:
Institute of Psychiatry, King's College, London, United Kingdom Research Centre for Health Promotion (HEMIL), University of Bergen, Bergen, Norway Division of Epidemiology, Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
O. Bjerkeset
Affiliation:
Department of Psychiatry, Hospital Levanger, Nord-Trøndelag Health Organization, Levanger, Norway Department of Neuroscience, Faculty of Medicine, National University for Science and Technology, HUNT Research Centre, Trondheim, Norway
R. Stewart
Affiliation:
Institute of Psychiatry, King's College, London, United Kingdom
M. Dewey
Affiliation:
Institute of Psychiatry, King's College, London, United Kingdom
S. Overland
Affiliation:
Research Centre for Health Promotion (HEMIL), University of Bergen, Bergen, Norway
M. Prince
Affiliation:
Institute of Psychiatry, King's College, London, United Kingdom

Abstract

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Background and Aims

Depression is reported to be associated with increased mortality, but underlying mechanisms are uncertain. Associations between anxiety and mortality are also uncertain. In a large population study, we investigated associations between anxiety, depression and mortality over a 3-6 year period. We utilized a unique link between a large regional community survey and a comprehensive national mortality database.

Methods

Baseline information on mental and physical health was collected in a population-based health study (n=61,349) (the HUNT-2 study) of adults aged 20 years and over. Anxiety and depressive symptoms were ascertained using the Hospital Anxiety and Depression Scale (HADS). Records were linked with the Norwegian national mortality database.

Results

Case-level depression was a risk-factor for mortality, but case-level anxiety was not (having adjusted for confounding factors). The association between anxiety symptoms and mortality was U-shaped, and anxiety comorbid with depression was associated with lower mortality compared to depression alone. Associations between depression and mortality were partly but not entirely explained by somatic symptoms and conditions, and also physical impairment, but not by smoking, obesity, cholesterol level or blood pressure.

Conclusions

Depression predicted general mortality after adjustment for multiple potential confounding factors. Associations between anxiety symptoms and mortality were U-shaped. Lower mortality was found in comorbid anxiety and depression than in depression alone.

Type
S33. Symposium: Mortality and Mental Disorders: Suicide and Beyond
Copyright
Copyright © European Psychiatric Association 2007
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