Evidence is mounting that the mental health and physical health domains are intimately connected. This paper presents a conceptual model delineating hypothesized relationships between disturbed affect, unhealthy personal behaviors, and poor health outcomes. Analyses of Year 5 data from the CARDIA study (N=4252; ages 23-35) demonstrate associations between measures of depression and anxiety, and smoking and alcohol intake, and cardiovascular disease related hospitalizations and all-cause mortality during the subsequent 5 years. A total of 18 self-reported hospitalizations and 39 verified deaths occurred during this period.
Clinically significant levels of depression on the Center for Epidemiologic Studies Depression scale (scores > 16) were associated with greater likelihood of hospitalization (OR=5.66; 95% CI=(2.09, 15.30)) and greater likelihood of death (OR=2.11; 95% CI=(1.09, 4.09)) after adjusting for age, race, and gender. Similarly, participants with scores in the upper quintile of the population norms for the Spielberger State–Trait Anxiety Inventory had a greater chance of hospitalization (OR=4.28; 95% CI=(1.64, 11.17)), but no association was found with death. Unhealthy behaviors such as smoking and higher levels of alcohol intake were more prevalent in certain subgroups. African-American Women, African-American Men, and Caucasian Women with depression or high anxiety were more likely to be smokers (p’s ranging between .01 and .0007). Alcohol intake was also significantly higher among Black Men who were depressed or anxious (p=.005 and p=.01).
In summary, mental health problems have been found to be associated with contemporaneous unhealthy behaviors and with later adverse health events in this biracial longitudinal data set.
Learning Objectives: -- A simple model will be described that could further understanding of the reciprocal relationships between affect and behavior and health outcomes. -- Public health workers and health care providers will be encouraged to pay more attention to the diagnosis and treatment of depression and anxiety. -- Epidemiologists and other researchers will be stimulated to investigate and report evidence that either extends or disconfirms the findings reported here.
Keywords: Adult and Child Mental Health, Outcome Measures
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.