Levels of anxiety and depression as predictors of mortality: the HUNT study
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BACKGROUND: Depression is reported to be associated with increased mortality, although underlying mechanisms are uncertain. Associations between anxiety and mortality are also uncertain. AIMS: To 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. METHOD: We utilised a unique link between a large population survey (HUNT-2, n = 61 349) and a comprehensive mortality database. RESULTS: Case-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. CONCLUSIONS: Depression 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.
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Anxiety comorbid with depression reduces mortality compared with depression alone in Norwegian adults.
“Anxiety comorbid with depression was found to reduce mortality compared with depression alone in Norwegian adults [25].”
From Adaptive function and correlates of anxiety during a pandemic (2021) · cites this paper as [25]
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- Authors
- Mykletun, A., Bjerkeset, O., øverland, S., Prince, M., Dewey, M., & Stewart, R.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Norwegian University of Science and Technology (NO)
- University of Bergen (NO)
- King's College London (GB)
- Corresponding author
- Mykletun, Arnstein
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-08
- Volume
- 195
- Issue
- 2
- Pages
- 118-125
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2147161932
- Cited by
- 279
- References
- 43
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 13 · 2022: 14 · 2021: 22 · 2020: 19 · 2019: 14 · 2018: 15 · 2017: 12 · 2016: 20 · 2015: 11 · 2014: 22 · 2013: 35 · 2012: 17
- FWCI
- 15.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Norges Teknisk-Naturvitenskapelige Universitet
- National Institute for Health and Care Research
- King's College London
- Norges Forskningsråd
- Norwegian Institute of Public Health
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, anxiety, mortality, comorbid depression and anxiety, Hospital Anxiety and Depression Scale, smoking, somatic symptoms, U-shaped relationship, HUNT study, risk factors
- MeSH terms
- Adult, Aged, Anxiety Disorders, Cause of Death, Depressive Disorder, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Norway, Comorbidity, Confounding Factors, Epidemiologic, Young Adult
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