Mykletun Arnstein, Bjerkeset Ottar, Overland Simon, Prince Martin, Dewey Michael, Stewart Robert
Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Christiesgt 13 N-5015 Bergen, Norway.
Br J Psychiatry. 2009 Aug;195(2):118-25. doi: 10.1192/bjp.bp.108.054866.
Depression is reported to be associated with increased mortality, although underlying mechanisms are uncertain. Associations between anxiety and mortality are also uncertain.
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.
We utilised a unique link between a large population survey (HUNT-2, n = 61 349) and a comprehensive mortality database.
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.
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.
据报道，抑郁症与死亡率增加有关，但其潜在机制尚不确定。焦虑与死亡率之间的关联也不明确。
调查个体及合并的焦虑/抑郁症状负荷（使用医院焦虑抑郁量表（HADS））与3至6年期间死亡率之间的关联。
我们利用了一项大型人口调查（HUNT-2，n = 61349）与一个综合死亡率数据库之间的独特联系。
病例水平的抑郁症与死亡率增加相关（风险比（HR）= 1.52，95%置信区间1.35 - 1.72），与吸烟相当（HR = 1.59，95%置信区间1.44 - 1.75），且仅部分由躯体症状/疾病解释。与单纯抑郁症相比，伴有焦虑的抑郁症降低了死亡率（焦虑与抑郁的相互作用P = 0.017）。焦虑症状负荷与死亡率之间的关联呈U形。
抑郁症作为死亡率的危险因素，其强度与吸烟相当。与单纯抑郁症相比，合并焦虑降低了死亡率。焦虑症状与死亡率之间的关系更为复杂，呈U形，且焦虑症状负荷最低者死亡率最高。
