No Health Without Mental Health

Are depression and/or anxiety associated with higher rates of accumulating chronic conditions than having neither condition?

a graph of a number of people with different colored lines

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Can treating mental illness help prevent the onset of other chronic disease? Dr. William Bobo and his team of researchers say it’s possible.

Anxiety and depression are like flip sides of the same coin; individuals with one disease are likely to have the other. The researchers explored the question: are depression and/or anxiety (alone or combined) associated with higher rates of accumulating chronic conditions than having neither condition? They studied medical records from 40,360 residents of Olmsted County, Minnesota from 2005 to 2014.

Participants were divided into three groups: those who had their 20th, 40th, or 60th birthday during the study period, and then further classified as already having a diagnosis of depression, anxiety, both, or neither. The study team then compared how often and how quickly people accumulated 15 chronic conditions including hypertension, asthma, heart and lung disease, and most cancers.

Women in all three age groups and men in their 20s who had either depression or anxiety and depression were at a significantly higher risk of developing a chronic condition compared with participants with neither diagnosis. The figures show, on average, how many new chronic conditions were diagnosed over a decade for patients in their 20s. The blue line shows chronic diseases increased at the fastest rate among people with both depression and anxiety. The researchers hypothesized that this trend was stronger for women because they are more likely to be diagnosed with anxiety or depression than men.

More Americans are developing multiple chronic conditions over time, and these numbers are expected to increase. Among older adults, depression and anxiety are associated with general illnesses at a scale similar to smoking. While researchers know that mental and physical illness mutually reinforce each other, these new study findings support evidence of biological mechanisms linking mental illness with development of chronic conditions over the life course.

The CDC reports rates of adult anxiety or depression rose from 36 to 41% from August 2020 to February 2021.  As Dr. Brock Chisholm of the World Health Organization famously stated, “without mental health there can be no true physical health.”

Databyte via William V. Bobo, Brandon R. Grossardt, Sanya Virani, et al. Association of Depression and Anxiety With the Accumulation of Chronic Conditions. JAMA Network Open, 2022.