SEATTLE – Anxiety disorders are associated with a wide range of physical health problems, even after adjustment for other common mental disorders such as depression, Dr. Jitender Sareen 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. They 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 used 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, and social phobia.
The investigators looked at disability and functional impairment, and then controlled for factors such as depression, alcohol use, and pain. But even after they adjusted for common mood and substance abuse disorders, pain, and sociodemographics, anxiety disorders remained associated with a high level of disability and greater role impairment.
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. Neurologic conditions, including epilepsy, multiple sclerosis, and stroke, were also highly prevalent. Other associated disorders included vascular conditions, respiratory illnesses, gastrointestinal disease, bone or joint disorders, and diseases like cancer and AIDS.
Subjects reporting a diagnosis of panic attacks and agoraphobia were also highly likely to have a comorbid medical condition, especially a vascular disease or a bone or joint disorder. Dr. Sareen and his colleagues found that generalized anxiety disorder and social or simple phobias were also associated with physical illnesses, but the prevalence was lower.
There is a strong and unique association between anxiety disorders and physical disorders, the researchers concluded, and 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,” he said.