SEATTLE — Anxiety disorders are associated with a wide range of physical health problems, even after adjusting for other common mental disorders such as depression, Jitender Sareen, M.D., said in a poster presentation at the annual conference of the Anxiety Disorders Association of America.
“There has long been an interest in understanding how depression affects physical health,” said Dr. Sareen, of the department of psychiatry at the University of Manitoba, Winnipeg. “However, there have only been a few studies which have examined the relationship between anxiety disorders and medical conditions.”
The researchers used data derived from the U.S. National Comorbidity Survey, a national representative sample of 5,877 individuals aged 15–54 years, to examine the relationship between anxiety disorders and a wide range of medical conditions. The researchers used the Composite International Diagnostic Interview to make DSM-III-R mental disorder diagnoses, and assessed participants' general physical conditions on the basis of self-report. Multiple logistic regression was employed to analyze the relationship between a past-year anxiety disorder diagnosis and past-year chronic physical illness.
Anxiety disorders diagnosed among the survey participants during the previous year included posttraumatic stress disorder, panic attacks, agoraphobia, generalized anxiety disorder, social phobia, and simple phobia.
Dr. Sareen and his associates looked at disability and functional impairment, and controlled for factors such as depression, alcohol use, and pain. Even after adjusting for common mood and substance abuse disorders, pain, and sociodemographics, they found that anxiety disorders were associated with a high level of disability.
Among the anxiety disorders, posttraumatic stress disorder was linked to the widest range of physical conditions, with the most prevalent being any type of metabolic or autoimmune condition (adjusted odds ratio 3.26). Neurologic conditions, including epilepsy, multiple sclerosis, and stroke, were also highly prevalent (adjusted odds ratio 2.84).
The presence of an anxiety disorder among patients with physical disorders may confer a greater level of disability.
“We have found that anxiety disorders are related to physical health, much in the same way that depression is,” Dr. Sareen said. “And what we are showing is that not only are they related, but they raise disability in the community.”