The association between mood and anxiety disorders with vascular diseases and risk factors in a nationally representative sample

Objective

To investigate the association between mood and anxiety disorders and vascular diseases after controlling for vascular disease risk factors.

Methods

Using a nationally representative sample of adults (N=5692) from the National Comorbidity Survey-Replication (NCS-R), participants with mood disorders were hierarchically classified as having any lifetime history of mania, hypomania, or major depression. Anxiety disorders were also assessed. The reference group consisted of those without mental disorders. Vascular disease was determined by self-reported history of heart disease, heart attack, or stroke on the NCS-R survey. Vascular risk factors included diabetes, high blood pressure, and obesity.

Results

In multivariate logistic regression models that controlled for obesity, high blood pressure, smoking and diabetes, vascular disease was associated with bipolar disorder in women [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.63-4.80], and major depressive disorder in men (OR 1.85, 95% CI 1.17-2.92). Controlling for anxiety disorders reduced the associations in both men and women, and in fact, anxiety disorders were more strongly associated with vascular diseases in men, whereas bipolar disorder continued to be an important correlate of vascular disease in women.

Conclusion

These findings demonstrate the importance of evaluation of sex differences, mood disorder subtype and co-occurring anxiety disorders in assessing the association between mood disorders and vascular diseases. Future research should investigate potential biologic mechanisms for these associations in order to define potential targets for intervention.     

Association between obesity and psychiatric disorders in the US adult population

BACKGROUND: Epidemiologic data suggest an association between obesity and depression, but findings vary across studies and suggest a stronger relationship in women than men. OBJECTIVE: To evaluate the relationship between obesity and a range of mood, anxiety, and substance use disorders in the US general population. DESIGN: Cross-sectional epidemiologic survey. SETTING: Nationally representative sample of US adults. PARTICIPANTS: A total of 9125 respondents who provided complete data on psychiatric disorder, height, and weight. Response rate was 70.9%. MAIN OUTCOME MEASURES: Participants completed an in-person interview, including assessment of a range of mental disorders (assessed using the World Health Organization Composite International Diagnostic Interview) and height and weight (by self-report). RESULTS: Obesity (defined as body mass index [calculated as weight in kilograms divided by the square of height in meters] of > or =30) was associated with significant increases in lifetime diagnosis of major depression (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.09-1.35), bipolar disorder (OR, 1.47; 95% CI, 1.12-1.93), and panic disorder or agoraphobia (OR, 1.27; 95% CI, 1.01-1.60). Obesity was associated with significantly lower lifetime risk of substance use disorder (OR, 0.78; 95% CI, 0.65-0.93). Subgroup analyses found no difference in these associations between men and women, but the association between obesity and mood disorder was strongest in non-Hispanic whites (OR, 1.38; 95% CI, 1.20-1.59) and college graduates (OR, 1.44; 95% CI, 1.14-1.81). CONCLUSIONS: Obesity is associated with an approximately 25% increase in odds of mood and anxiety disorders and an approximately 25% decrease in odds of substance use disorders. Variation across demographic groups suggests that social or cultural factors may moderate or mediate the association between obesity and mood disorder.     

Peptic ulcer disease and mental illnesses

Objective

We evaluated the association between self-reported doctor-diagnosed peptic ulcer disease (PUD) and mental disorders in a representative cross-sectional study conducted in 2010 in Singapore.

Method

The sample comprised 6616 community-dwelling individuals. Participants were asked about a previous history of doctor-diagnosed PUD. Assessment of mental disorders was performed using the World Mental Health Composite International Diagnostic Interview version 3.0. Quality of life was assessed using the EuroQoL 5D.

Results

The weighted prevalence of PUD was 1.58% (95% CI=1.13–2.02). In adjusted analyses, PUD was more common among people with anxiety disorders [obsessive compulsive disorders (OR 4.22, 95% CI 1.59–11.21), Generalized Anxiety Disorders (OR 9.25, 95% CI 2.43-35.17), any anxiety disorders (OR 4.41, 95% CI 1.82-10.61)] and with any mood disorders (OR 2.66, 95% CI 1.08-6.53). PUD was associated with alcohol abuse and alcohol dependence, but not with smoking or nicotine dependence. Adjustment for nicotine and alcohol use attenuated the association of mood disorders with PUD, but not that of anxiety disorders. PUD was associated with reduced quality of life as measured on EuroQoL 5D, with further reduction in those with concomitant mental disorders.

Conclusion

PUD was associated with anxiety disorders, and this association is not attenuated with adjustment for nicotine dependence or alcohol use disorder.     

Mental disorders among persons with diabetes—Results from the World Mental Health Surveys

Objective

To estimate 12-month prevalence rate of mood, anxiety, and alcohol-use disorders among community samples of diabetic persons. We assess whether associations of specific mental disorders with diabetes are consistent across diverse countries after controlling for age and gender.

Research design and methods

Eighteen surveys of household-residing adults were conducted in two phases across 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific (Part 1, N=85,088). Mental disorders, identified by the World Mental Health-Composite International Diagnostic Interview, included anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder, and social phobia), mood disorders (dysthymia and major depressive disorder), and alcohol abuse/dependence. Diabetes was ascertained by self-report (Part 2, N=42,697). Association was assessed by age-gender adjusted odds ratios.

Results

Risk of mood and anxiety disorders was slightly higher among persons with diabetes relative to those without: odds ratio of 1.38 for depression (95% CI=1.15-1.66) and 1.20 for anxiety disorders, (95 % CI=1.01-1.42), after adjusting for age and gender. Odds ratio estimates across countries did not differ more than chance expectation. Alcohol-use disorders were uncommon among persons with diabetes in most countries, and not associated with diabetes in pooled survey data.

Conclusions

Population sample surveys revealed mood and anxiety disorders occurred with somewhat greater frequency among persons with diabetes than those without diabetes. Prevalence of major depression among persons with diabetes was lower in the general population than suggested by prior studies of clinical samples. Strength of association did not differ significantly across disorders or countries.     

Racial/ethnic differences in 12-month prevalence and persistence of mood,anxiety, and substance use disorders: Variation by nativity and socioeconomic status

BackgroundDespite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders.MethodData were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence.ResultsNon-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p < 0.001), though differences were also observed across minority groups. In contrast, Asian, Latino, and Black adults demonstrated higher 12-month prevalence of mood disorders among lifetime cases than Whites (p < 0.001) prior to adjustments Once we introduced nativity and other relevant controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or US-born Whites with two foreign parents (OR = 0.51, 95% CI = [0.36, 0.73]); this group also demonstrated higher odds of past-year mood disorder than Asian (OR = 0.59, 95% CI = [0.42, 0.82]) and Black (OR = 0.70, 95% CI = [0.58, 0.83]) adults, but not Latino adults (OR = 0.89, 95% CI = [0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance disorder prevalence were moderated by educational attainment, especially among adults without a college education. Additionally, racial/ethnic minority groups with no more than a high school education demonstrated more persistent mood and substance disorders than non-Latino Whites; these relationships reversed or disappeared at higher education levels.ConclusionNativity may be a particularly relevant consideration for diagnosing mood disorder among non-Latino Whites; additionally, lower education appears to be associated with increased relative risk of persistent mood and substance use disorders among racial/ethnic minorities compared to non-Latino Whites.     

The 12-month prevalence of DSM-IV anxiety disorders among Nigerian secondary school adolescents aged 13-18 years

AIMS: To estimate the 12-month prevalence of DSM-IV-specific anxiety disorders among Nigerian secondary school adolescents aged 13-18 years. METHOD: A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. RESULTS: The 12-month prevalence for all anxiety disorders was 15.0% (females=19.6%; males=11.4%). There were significant gender differences in the prevalence for all anxiety disorders (P<0.001; OR 1.96, 95% CI 1.35-2.65) and social anxiety disorder (P=0.035; OR 1.82, 95% CI 1.03-3.19) and significant age difference in the prevalence of separation anxiety disorder (P=0.045; OR 2.43, 95% CI 0.99-5.96). CONCLUSION: The prevalence of anxiety disorders in Nigerian secondary school adolescents was comparable to the rates found in the western world. Health policies must integrate adolescents' anxiety as a disorder of public health significance. Further studies are needed to evaluate the factors associated with anxiety disorders amongst adolescents in this region.     

The association between arthritis and psychiatric disorders; results from a longitudinal population-based study

Background

To disentangle cross-sectionally and longitudinally the relationship between arthritis and psychiatric disorders, and to examine the relationship between age and incidence of (1) any psychiatric disorder among respondents with and without arthritis and (2) arthritis among respondents with and without any psychiatric disorder.

Methods

Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a nationally representative household survey with repeated measurements in 1996, 1997 and 1999. Self-report was used to ascertain arthritis. Psychiatric and substance use disorders were diagnosed with the WHO Composite International Diagnostic Interview.

Results

Regarding the cross-sectional results, it was found that the strength of the association of arthritis with mood and anxiety disorders was similar [odds ratio (OR)=1.48, 95% confidence interval (CI)=1.09-1.99 and OR=1.42, 95% CI=1.11-1.81, respectively]. The longitudinal results showed that preexisting arthritis elevated the risk of developing any mood disorder (OR=1.94, 95% CI=1.23-3.07), whereas having any mood or any anxiety disorder did not predict new-onset arthritis. The incidence of any psychiatric disorder was significantly higher among younger persons (<45 years) with arthritis, compared to others in the same age category without arthritis.

Conclusions

Arthritis is associated with psychiatric disorders. The temporal relationship points to one direction: arthritis predicts new onset of psychiatric disorder (mood disorder) instead of the reverse. Especially younger people (<45 years) with arthritis are at risk of developing a psychiatric disorder. Screening and simultaneous treatment of comorbid mood disorder and arthritis are recommended as part of routine in primary care.     

Same-sex sexual behavior and psychiatric disorders: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

BACKGROUND: It has been suggested that homosexuality is associated with psychiatric morbidity. This study examined differences between heterosexually and homosexually active subjects in 12-month and lifetime prevalence of DSM-III-R mood, anxiety, and substance use disorders in a representative sample of the Dutch population (N = 7076; aged 18-64 years). METHODS: Data were collected in face-to-face interviews, using the Composite International Diagnostic Interview. Classification as heterosexual or homosexual was based on reported sexual behavior in the preceding year. Five thousand nine hundred ninety-eight (84.8%) of the total sample could be classified: 2.8% of 2878 men and 1.4% of 3120 women had had same-sex partners. Differences in prevalence rates were tested by logistic regression analyses, controlling for demographics. RESULTS: Psychiatric disorders were more prevalent among homosexually active people compared with heterosexually active people. Homosexual men had a higher 12-month prevalence of mood disorders (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.54-5.57) and anxiety disorders (OR = 2.61; 95% CI = 1.44-4.74) than heterosexual men. Homosexual women had a higher 12-month prevalence of substance use disorders (OR = 4.05; 95% CI = 1.56-10.47) than heterosexual women. Lifetime prevalence rates reflect identical differences, except for mood disorders, which were more frequently observed in homosexual than in heterosexual women (OR = 2.41; 95% CI = 1.26-4.63). The proportion of persons with 1 or more diagnoses differed only between homosexual and heterosexual women (lifetime OR = 2.61; 95% CI = 1. 31-5.19). More homosexual than heterosexual persons had 2 or more disorders during their lifetimes (homosexual men: OR = 2.70; 95% CI = 1.66-4.41; homosexual women: OR = 2.09; 95% CI = 1.07-4.09). CONCLUSION: The findings support the assumption that people with same-sex sexual behavior are at greater risk for psychiatric disorders.     

Civilians in World War II and DSM-IV mental disorders: results from the World Mental Health Survey Initiative

Purpose

Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders.

Methods

Adults (n?=?3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence).

Results

Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7).

Conclusions

Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.

     

Depressive and anxiety disorders and risk of subclinical atherosclerosis: Findings from the Netherlands Study of Depression and Anxiety (NESDA)

Objective

Current evidence regarding the association between psychopathology and subclinical atherosclerosis show inconsistent results. The present study examined whether subclinical atherosclerosis was more prevalent in a large cohort of persons with depressive or anxiety disorders as compared to non-depressed and non-anxious controls.

Methods

Baseline data from the Netherlands Study of Depression and Anxiety were used, including 2717 persons, free of clinical cardiovascular disease. Participants had a DSM-IV-based current or remitted depressive (major depressive disorder, dysthymia) or anxiety (social phobia, generalized anxiety disorder, panic disorder, agoraphobia) disorder (n=2115) or were healthy controls (n=602). Additional clinical characteristics (severity, duration, age of onset and medication) were assessed. Ankle-brachial index (ABI) was used as a measure of vascular risk and was categorized as low (≤0.90) and mildly low ABI (0.90-1.11) indicating subclinical atherosclerosis, and high ABI (>1.40), which was previously designated as a cardiovascular risk factor, reflecting arterial stiffness and wall calcification.

Results

As compared to normal controls, persons with current (i.e., past year) depressive, anxiety or comorbid depressive and anxiety disorders showed a two- to threefold increased odds of low ABI (OR=2.78, 95% CI=1.05-7.35; OR=3.14, 95% CI=1.25-7.85; OR=2.67, 95% CI=1.09-6.51, respectively). No associations were found with mildly low or high ABI. Also, we did not further find a differential role for symptoms severity, duration, age of onset, and use of psychotropic medication in the link between psychopathology and subclinical atherosclerosis.

Conclusion

Persons with current depressive or anxiety disorders were more likely to have subclinical atherosclerosis compared to healthy controls.     

Obesity and mental disorders in the adult general population

OBJECTIVE: The aim of this study was to investigate (i) the associations between mental disorders (in particular the anxiety disorders) and obesity in the general population and (ii) potential moderators of those associations (ethnicity, age, sex, and education). METHODS: A nationally representative face-to-face household survey was conducted in New Zealand with 12,992 participants 16 years and older, achieving a response rate of 73.3%. Ethnic subgroups (Maori and Pacific peoples) were oversampled. Mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). Height and weight were self-reported. Obesity was defined as a body mass index (BMI) of 30 kg/m(2) or greater. RESULTS: Obesity was significantly associated with any mood disorder (OR 1.23), major depressive disorder (OR 1.27), any anxiety disorder (OR 1.46), and most strongly with some individual anxiety disorders such as post-traumatic stress disorder (PTSD) (OR 2.64). Sociodemographic correlates moderated the association between obesity and mood disorders but were less influential in obesity-anxiety disorder associations. Adjustment for the comorbidity between anxiety and mood disorders made little difference to the relationship between obesity and anxiety disorders (OR 1.36) but rendered the association between obesity and mood disorders insignificant (OR 1.05). CONCLUSION: Stronger associations were observed between anxiety disorders and obesity than between mood disorders and obesity; the association between PTSD and obesity is a novel finding. These findings are interpreted in light of research on the role of anxiety in eating pathology, and deserve the further attention of researchers and clinicians.     

What characteristics of primary anxiety disorders predict subsequent major depressive disorder?

OBJECTIVE: The goal of this study was to examine the associations between specific anxiety disorders and the risk of major depressive disorder and to explore the role of various clinical characteristics of anxiety disorders in these relationships using a prospective, longitudinal design. METHOD: The data are from a 4-year prospective, longitudinal community study, which included both baseline and follow-up survey data on 2548 adolescents and young adults aged 14 to 24 years at baseline. DSM-IV diagnoses were made using the Munich-Composite International Diagnostic Interview. RESULTS: The presence at baseline of any anxiety disorder (odds ratio [OR] = 2.2 [95% CI = 1.6 to 3.2]) and each of the anxiety disorders (specific phobia, OR = 1.9 [95% CI = 1.3 to 2.8]; social phobia, OR = 2.9 [95% CI = 1.7 to 4.8]; agoraphobia, OR = 3.1 [95% CI = 1.4 to 6.7]; panic disorder, OR = 3.4 [95% CI = 1.2 to 9.0]; generalized anxiety disorder, OR = 4.5 [95% CI = 1.9 to 10.3]) was associated with a significantly (p <.05) increased risk of first onset of major depressive disorder. These associations remained significant after we adjusted for mental disorders occurring prior to the onset of the anxiety disorder, with the exception of the panic disorder association. The following clinical characteristics of anxiety disorders were associated with a significantly (p <.05) increased risk of developing major depressive disorder: more than 1 anxiety disorder, severe impairment due to the anxiety disorder, and comorbid panic attacks. In the final model, which included all clinical characteristics, severe impairment remained the only clinical characteristic that was an independent predictor of the development of major depressive disorder (OR = 2.2 [95% CI = 1.0 to 4.4]). CONCLUSION: Our findings suggest that anxiety disorders are risk factors for the first onset of major depressive disorder. Although a number of clinical characteristics of anxiety disorders appear to play a role in the association between anxiety disorders and depression, severe impairment is the strongest predictor of major depressive disorder.     

Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans

Our understanding of the relationship between immigration and mental health can be advanced by comparing immigrants pre- and post-immigration with residents of the immigrants' home countries. DSM-IV anxiety and mood disorders were assessed using identical methods in representative samples of English-speaking Mexican immigrants to the US, a subsample of the US National Comorbidity Survey Replication (NCSR), and Mexicans, the Mexican National Comorbidity Survey (MNCS). Retrospective reports of age of onset of disorders and, in the immigrant sample, age of immigration were analyzed to study the associations of pre-existing mental disorders with immigration and of immigration with the subsequent onset and persistence of mental disorders. Pre-existing anxiety disorders predicted immigration (OR=3.0; 95% CI 1.2-7.4). Immigration predicted subsequent onset of anxiety (OR=1.9; 95% CI 0.9-3.9) and mood (OR=2.3; 95% CI 1.3-4.0) disorders and persistence of anxiety (OR=3.7 95% CI 1.2-11.2) disorders. The results are inconsistent with the "healthy immigrant" hypothesis (that mentally healthy people immigrate) and partly consistent with the "acculturation stress" hypothesis (i.e., that stresses of living in a foreign culture promote mental disorder). Replication and extension of these results in a larger bi-national sample using a single field staff are needed.     

“Anxietas Tibiarum”

Abstract Background Symptoms of anxiety and depression in patients with restless legs syndrome (RLS) have been observed. However, it is unclear whether rates of threshold depression and anxiety disorders according to DSM-IV criteria in such patients are also elevated. Methods 238 RLS patients were assessed with a standardized diagnostic interview (Munich-Composite International Diagnostic Interview for DSM-IV) validated for subjects aged 18–65 years. Rates of anxiety and depressive disorders were compared between 130 RLS patients within this age range and 2265 community respondents from a nationally representative sample with somatic morbidity of other types. Results RLS patients revealed an increased risk of having 12-month anxiety and depressive disorders with particularly strong associations with panic disorder (OR=4.7; 95% CI=2.1–10.1), generalized anxiety disorder (OR=3.5; 95% CI= 1.7–7.1), and major depression (OR=2.6; 95% CI=1.5–4.4). In addition, lifetime rates of panic disorder and most depressive disorders as well as comorbid depression and anxiety disorders were considerably increased among RLS patients compared with controls. Conclusions The results suggest that RLS patients are at increased risk of having specific anxiety and depressive disorders. Causal attributions of patients suggest that a considerable proportion of the excess morbidity for depression and panic disorder might be due to RLS symptomatology.     

Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions

BACKGROUND: Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. OBJECTIVE: To present nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). DESIGN: Face-to-face survey. SETTING: The United States. PARTICIPANTS: Household and group quarters' residents. MAIN OUTCOME MEASURES: Prevalence and associations of substance use disorders and independent mood and anxiety disorders. RESULTS: The prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant (P<.05). CONCLUSIONS: Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.     

Comorbid anxiety disorders alter the association between cardiovascular diseases and depression: the German National Health Interview and Examination Survey

Purpose

This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs).

Methods

In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety).

Results

There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04–2.50) as was panic disorder (OR 2.89; 95 % CI 1.47–5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55–5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09–4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04–1.78).

Conclusions

Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs, independent from covariates and depression.     

Mental disorders among persons with diabetes—Results from the World Mental Health Surveys

ObjectiveTo estimate 12-month prevalence rate of mood, anxiety, and alcohol-use disorders among community samples of diabetic persons. We assess whether associations of specific mental disorders with diabetes are consistent across diverse countries after controlling for age and gender.Research design and methodsEighteen surveys of household-residing adults were conducted in two phases across 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific (Part 1, N=85,088). Mental disorders, identified by the World Mental Health–Composite International Diagnostic Interview, included anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder, and social phobia), mood disorders (dysthymia and major depressive disorder), and alcohol abuse/dependence. Diabetes was ascertained by self-report (Part 2, N=42,697). Association was assessed by age–gender adjusted odds ratios.ResultsRisk of mood and anxiety disorders was slightly higher among persons with diabetes relative to those without: odds ratio of 1.38 for depression (95% CI=1.15–1.66) and 1.20 for anxiety disorders, (95 % CI=1.01–1.42), after adjusting for age and gender. Odds ratio estimates across countries did not differ more than chance expectation. Alcohol-use disorders were uncommon among persons with diabetes in most countries, and not associated with diabetes in pooled survey data.ConclusionsPopulation sample surveys revealed mood and anxiety disorders occurred with somewhat greater frequency among persons with diabetes than those without diabetes. Prevalence of major depression among persons with diabetes was lower in the general population than suggested by prior studies of clinical samples. Strength of association did not differ significantly across disorders or countries.     

Mental disorders and asthma in the community

OBJECTIVE: To determine the association between asthma and mental disorders among adults in the community. SETTING: Germany. PARTICIPANTS: Representative sample of the general population aged 18 to 65 years. MAIN OUTCOME MEASURES: Diagnoses of current (the past 4 weeks) and lifetime asthma were based on physician diagnosis; current and lifetime DSM-IV mental disorders were assessed using the Composite International Diagnostic Interview. RESULTS: Current severe asthma (the past 4 weeks) was associated with a significantly increased likelihood of any anxiety disorder (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.35-5.18), specific phobia (OR, 4.78; 95% CI, 2.35-4.05), panic disorder (OR, 4.61; 95% CI, 1.09-9.4), and panic attacks (OR, 4.12; 95% CI, 1.32-12.8). Lifetime severe asthma was associated with the increased likelihood of any anxiety disorder (OR, 2.09; 1.3-3.36), panic disorder (OR, 2.61; 95% CI, 1.29-5.25), panic attacks (OR, 2.84; 95% CI, 1.66, 4.89), social phobia (OR, 3.28; 95% CI, 1.42, 7.59), specific phobia (OR, 2.93; 95% CI, 1.71-5.0), generalized anxiety disorder (OR, 5.51; 95% CI, 2.29-13.22), and bipolar disorder (OR, 5.64; 95% CI, 1.95-16.35). Current nonsevere asthma was associated with the increased likelihood of any affective disorder (OR, 2.42; 95% CI, 1.03-5.72); and lifetime nonsevere asthma was associated with increased odds of any anxiety disorder (OR, 1.51; 95% CI, 1.0-2.32), anxiety disorder not otherwise specified (OR, 2.08; 95% CI, 1.03-4.23), and any somatoform disorder (OR, 1.7; 95% CI, 1.14-2.53). CONCLUSIONS: To our knowledge, these findings are consistent with and extend the findings of previous reports by providing the first available information on the association between physician-diagnosed asthma and DSM-IV mental disorders in a representative population sample of adults. Our results suggest an association between asthma and a range of mental disorders. Longitudinal studies that can examine the sequence of onset and the role of genetic and environmental factors in the association between asthma and affective and anxiety disorders are needed next to further elucidate possible shared causative mechanisms.     

Cardiovascular disease and psychiatric disorders among Latinos in the United States

Purpose

Cardiovascular disease (CVD) is the leading cause of death among Latinos and disproportionately impacts people with psychiatric disorders. The aim of this study was to examine the relationships between CVD and psychiatric disorders among different Latino subgroups using a nationally representative sample.

Methods

Latinos participants (N = 6359) were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. A structured diagnostic interview was used to determine psychiatric diagnoses for any past-year mood, anxiety, and substance use disorders. A self-reported measure of physician-confirmed CVD was used. The relationships between CVD and psychiatric disorders among Latino subgroups were examined with logistic regression models adjusting for sociodemographics, CVD-risk factors, and acculturation.

Results

CVD were highest among Puerto Ricans (12%) and Cubans (11%), followed by Other Latinos (7%) and Mexicans (5%). The relationship between psychiatric disorders and CVD differed by Latino subgroups. Significantly increased odds of CVD were found among Mexicans with any past-year mood and anxiety disorders, Puerto Ricans with any past-year psychiatric disorders, Cubans with any past-year mood and substance abuse disorders, and Other Latinos with any past-year mood, anxiety, and lifetime schizophrenia/psychotic disorders.

Conclusions

The associations between CVD and psychiatric disorders are not uniform among Latinos. Efforts to address the need for health and mental health services must carefully consider this heterogeneity.

     

The relation between obesity and depressed mood in a multi-ethnic population. The HELIUS study

Purpose

To examine the association between obesity and depressed mood in a large multi-ethnic population and check for consistency in this association across six ethnic groups.

Methods

Data of 21,030 persons (18–70 years) were sourced from the HELIUS study. Cross-sectional relationships between obesity measures [body mass index (kg/m²) and waist circumference (cm)] and depressed mood (PHQ-9 score?≥?10) were analysed. Consistency of associations was investigated across ethnic groups by interaction terms (ethnicity*obesity measures) in basic (age, sex, education) and fully (health behaviours and somatic health) adjusted models.

Results

Obesity was prevalent in all ethnic groups, but varied substantially. After sociodemographic adjustment, obesity measures were associated with increased odds of depressed mood but this was inconsistent across ethnic groups. Obesity (BMI?≥?30 or highest waist circumference quartile) was strongly and significantly associated with depressed mood in the Dutch [Odds Ratio (OR)?=?1.72; 95% Confidence intervals (CI) 1.24–2.40, and OR?=?1.86; 95% CI 1.38–2.50], respectively, and African Surinamese (OR?=?1.60; 95% CI 1.29–1.98 and OR?=?1.59; 95% CI 1.27–2.00, respectively) but had a weaker, non-significant association in other ethnic groups (South-Asian Surinamese, Ghanaian, Moroccan, Turkish groups). Adjustment for health behaviours and somatic health had limited effect on this pattern.

Conclusion

Obesity was associated with a higher risk of depressed mood. However, ethnic differences were found: the obesity-depressed mood association was strong in the Dutch and African Surinamese populations, but not in other ethnic groups. Future studies should explore whether differential normative values or pathophysiology across ethnic groups explain why the obesity-depression association is inconsistent across ethnic groups.