Author:
Mykletun Arnstein,Bjerkeset Ottar,øverland Simon,Prince Martin,Dewey Michael,Stewart Robert
Abstract
BackgroundDepression is reported to be associated with increased mortality,
although underlying mechanisms are uncertain. Associations between
anxiety and mortality are also uncertain.AimsTo investigate associations between individual and combined
anxiety/depression symptom loads (using the Hospital Anxiety and
Depression Scale (HADS)) and mortality over a 3–6 year period.MethodWe utilised a unique link between a large population survey (HUNT–2,
n = 61 349) and a comprehensive mortality
database.ResultsCase-level depression was associated with increased mortality (hazard
ratio (HR) = 1.52, 95% CI 1.35–1.72) comparable with that of smoking (HR
= 1.59, 95% CI 1.44–1.75), and which was only partly explained by somatic
symptoms/conditions. Anxiety comorbid with depression lowered mortality
compared with depression alone (anxiety depression interaction
P = 0.017). The association between anxiety symptom
load and mortality was U-shaped.ConclusionsDepression as a risk factor for mortality was comparable in strength to
smoking. Comorbid anxiety reduced mortality compared with depression
alone. The relationship between anxiety symptoms and mortality was more
complex with a U-shape and highest mortality in those with the lowest
anxiety symptom loads.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health