Levels of anxiety and depression as predictors of mortality: the HUNT study
Levels of anxiety and depression as predictors of mortality: the HUNT study
复制标题
DOI：
10.1192/bjp.bp.108.054866
复制
发表时间：
2009-08-01
影响因子：
10.5
通讯作者：
Stewart, Robert
中科院分区：
文献类型：
--
作者：
Mykletun, Arnstein;Bjerkeset, Ottar;Stewart, Robert
背景抑郁症与死亡率增加有关，但其潜在机制尚不清楚。焦虑和死亡率之间的关系也是不确定的。目的探讨个体和组合焦虑/抑郁症状负荷之间的关系（使用医院焦虑和抑郁量表（HADS））和3-6年期间的死亡率。（HUNT-2，n = 61349）和一个综合死亡率数据库。（风险比（HR）= 1.52，95%CI 1.35-1.72）与吸烟（HR = 1.59，95%CI 1.44-1.75）相当，并且仅部分由躯体症状/状况解释。与单纯抑郁症相比，焦虑与抑郁共病降低了死亡率（焦虑抑郁相互作用P=0.017）。焦虑症状负荷和死亡率之间的关联是U形的。ConclusionsDepression作为死亡率的危险因素是可比的强度吸烟。与单纯抑郁症相比，共病焦虑降低了死亡率。焦虑症状与死亡率之间的关系更为复杂，呈U形，焦虑症状负荷最低的患者死亡率最高。
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 = 61349) 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.