Depression, anxiety as risky as smoking and obesity: study

Findings suggest greater integration of mental health treatment is needed in primary care

Depression and anxiety are on a par with obesity and smoking when it comes to risk factors for future physical health, US research shows.


The authors say the findings suggest greater attention should be given to both conditions in primary care, and to consider a mental health approach for patients presenting with somatic symptoms.

The study used data from more than 15,400 people (mean age, 68) enrolled in the University of Michigan’s Health and Retirement Study to examine whether depression and anxiety at baseline predicted self-reported ill-health four years later.

Having depression or anxiety put people at a similar risk of later heart conditions, stroke, and hypertension as being obese or being a current smoker, the researcher reported in Health Psychology.

And while obesity conferred a greater risk of diabetes than depression or anxiety, these mental health conditions increased the risk of arthritis more than current smoking, they said.

“These findings highlight the relative importance of anxiety and depression compared with widely accepted risk factors for medical illnesses and somatic complaints such as obesity and smoking,” they wrote.

Unsurprisingly, somatic symptoms, such as dizziness, light-headedness, back pain, headaches, stomach problems, and impaired eyesight were predicted more strongly by depression or anxiety than by current smoking or obesity, the University of California San Francisco authors reported.

As somatic complaints were common presenting problems in primary care, and often proved difficult to treat, the treatment of anxiety and depression could expand potential therapy options for such complaints, they suggested.

Anxiety and depression impacted the hypothalamic-pituitary-axis, the autonomic nervous system, the immune system and telomere maintenance systems, and so could affect the risk of developing illness, they noted.

Furthermore, although much of the analysis was carried out using a composite of anxiety and depression scores, the results showed that each condition independently raised the odds of illness.

An exception to the pattern was cancer, where despite patient belief to the contrary, being anxious or depressed did not appear to up the odds, the researchers said.

“Our findings are in line with a lot of other studies showing that psychological distress is not a strong predictor of many types of cancer,” said senior author and assistant professor of psychiatry, Dr Aoife O’Donovan (PhD).

A limitation of the study was that it used self-reported illness. Further research using objectively measured illness was needed to corroborate their results, the authors concluded.

More information: Health Psychology 2018.