Mental Health and Physical Health

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Volume 15, Number 6

If asked to identify risk factors for chronic illnesses such as diabetes, high blood pressure, heart disease, stroke, cancer, and arthritis, it is likely that the common responses of most persons would include obesity, smoking, and a sedentary lifestyle. How frequently would depression and/or anxiety be mentioned?

          In a study published this year in Health Psychology, investigators from the San Francisco VA Medical Center and the University of California, San Francisco, used data from the national Health and Retirement Study (HRS) to predict the new onset of medical illnesses or somatic symptoms over a four year period. Their sample included over 15,000 adults with a mean age of 68. The presence of anxiety and depression in this sample was approximately 15%, similar to other population data. In this study, a combined anxiety and depression score was either as predictive or more predictive of the new onset of medical conditions or somatic symptoms (pain, shortness of breath, stomach problems, back pain, dizziness, headache, and eyesight difficulties) than was obesity and smoking. The exceptions were diabetes (obesity was more predictive) and cancer.

          Furthermore, the increased risk for medical illness and somatic symptoms associated with anxiety and depression was present, even after controlling for any risk associated with age, gender, race, ethnicity, marital status, education, alcohol use, physical activity, smoking, and body mass index. And while the main focus of the study was the prediction of the onset of illness or symptoms, the investigators also found that anxiety and depression were predictive of worsening of symptoms that were already present at the outset of the four-year period.

          Anxiety and depression are commonly regarded as mental health problems that detract from quality of life, can become quite disabling, and warrant some type of treatment. However, anxiety and depression are not usually understood to be risk factors for chronic medical illnesses, and certainly not factors that convey as much risk as do smoking and obesity. While the study described here was conducted with “older” adults, other studies have found depression and/or anxiety to be predictive of subsequent medical problems in younger populations.

          The study authors urge that greater attention be given to anxiety and depression in primary care, given the increased health risk associated with them. A take-home point for those who aren’t healthcare professionals is that it is important to report the experience of anxiety and or depression to one’s primary care physician or other practitioner. Perhaps there can be additional impetus to do so when understanding that untreated depression or anxiety can increase one’s risk for high blood pressure, heart disease, stroke, and arthritis, as well as other physical symptoms.


Paul J. Hershberger, Ph.D.

… is a clinical health psychologist. He is Professor, Director of Research, and Director of the Division of Behavioral Health, Department of Family Medicine, Wright State University Boonshoft School of Medicine.




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