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Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study

BACKGROUND: To examine the mortality risk of current and life-time depressive as well as anxiety disorders, whether this risk is moderated by sex or age, and whether this risk can be explained by lifestyle and/or somatic health status. METHODS: A cohort study (Lifelines) including 141,377 participan...

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Autores principales: Oude Voshaar, R. C., Aprahamian, I., Borges, M. K., van den Brink, R. H. S., Marijnissen, R. M., Hoogendijk, E. O., van Munster, B., Jeuring, H. W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8446070/
https://www.ncbi.nlm.nih.gov/pubmed/34462033
http://dx.doi.org/10.1192/j.eurpsy.2021.2229
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author Oude Voshaar, R. C.
Aprahamian, I.
Borges, M. K.
van den Brink, R. H. S.
Marijnissen, R. M.
Hoogendijk, E. O.
van Munster, B.
Jeuring, H. W.
author_facet Oude Voshaar, R. C.
Aprahamian, I.
Borges, M. K.
van den Brink, R. H. S.
Marijnissen, R. M.
Hoogendijk, E. O.
van Munster, B.
Jeuring, H. W.
author_sort Oude Voshaar, R. C.
collection PubMed
description BACKGROUND: To examine the mortality risk of current and life-time depressive as well as anxiety disorders, whether this risk is moderated by sex or age, and whether this risk can be explained by lifestyle and/or somatic health status. METHODS: A cohort study (Lifelines) including 141,377 participants (18–93 years) which were followed-up regarding mortality for 8.6 years (range 3.0–13.7). Baseline depressive and anxiety disorders according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria were assessed with the Mini International Neuropsychiatric Interview and lifetime diagnoses by self-report. All-cause mortality was retrieved from Statistics Netherlands. Cox-regression was applied to calculate proportional hazard ratios, adjusted for lifestyle (physical activity, alcohol use, smoking, and body mass index) and somatic health status (multimorbidity and frailty) in different models. RESULTS: The mortality rate of depressive and anxiety disorders was conditional upon age but not on sex. Only in people below 60 years, current depressive and anxiety disorders were associated with mortality. Only depressive disorder and panic disorder independently predicted mortality when all mental disorders were included simultaneously in one overall model (hazard ratio [HR] = 2.18 [95% confidence intervals (CI): 1.56–3.05], p < 0.001 and HR = 2.39 [95% CI: 1.15–4.98], p = 0.020). Life-time depressive and anxiety disorders, however, were independent of each other associated with mortality. Associations hardly changed when adjusted for lifestyle characteristics but decreased substantially when adjusted for somatic health status (in particular physical frailty). CONCLUSIONS: In particular, depressive disorder is associated with excess mortality in people below 60 years, independent of their lifestyle. This effect seems partly explained by multimorbidity and frailty, which suggest that chronic disease management of depression-associated somatic morbidity needs to be (further) improved.
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spelling pubmed-84460702021-09-27 Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study Oude Voshaar, R. C. Aprahamian, I. Borges, M. K. van den Brink, R. H. S. Marijnissen, R. M. Hoogendijk, E. O. van Munster, B. Jeuring, H. W. Eur Psychiatry Research Article BACKGROUND: To examine the mortality risk of current and life-time depressive as well as anxiety disorders, whether this risk is moderated by sex or age, and whether this risk can be explained by lifestyle and/or somatic health status. METHODS: A cohort study (Lifelines) including 141,377 participants (18–93 years) which were followed-up regarding mortality for 8.6 years (range 3.0–13.7). Baseline depressive and anxiety disorders according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria were assessed with the Mini International Neuropsychiatric Interview and lifetime diagnoses by self-report. All-cause mortality was retrieved from Statistics Netherlands. Cox-regression was applied to calculate proportional hazard ratios, adjusted for lifestyle (physical activity, alcohol use, smoking, and body mass index) and somatic health status (multimorbidity and frailty) in different models. RESULTS: The mortality rate of depressive and anxiety disorders was conditional upon age but not on sex. Only in people below 60 years, current depressive and anxiety disorders were associated with mortality. Only depressive disorder and panic disorder independently predicted mortality when all mental disorders were included simultaneously in one overall model (hazard ratio [HR] = 2.18 [95% confidence intervals (CI): 1.56–3.05], p < 0.001 and HR = 2.39 [95% CI: 1.15–4.98], p = 0.020). Life-time depressive and anxiety disorders, however, were independent of each other associated with mortality. Associations hardly changed when adjusted for lifestyle characteristics but decreased substantially when adjusted for somatic health status (in particular physical frailty). CONCLUSIONS: In particular, depressive disorder is associated with excess mortality in people below 60 years, independent of their lifestyle. This effect seems partly explained by multimorbidity and frailty, which suggest that chronic disease management of depression-associated somatic morbidity needs to be (further) improved. Cambridge University Press 2021-08-31 /pmc/articles/PMC8446070/ /pubmed/34462033 http://dx.doi.org/10.1192/j.eurpsy.2021.2229 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use.
spellingShingle Research Article
Oude Voshaar, R. C.
Aprahamian, I.
Borges, M. K.
van den Brink, R. H. S.
Marijnissen, R. M.
Hoogendijk, E. O.
van Munster, B.
Jeuring, H. W.
Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study
title Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study
title_full Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study
title_fullStr Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study
title_full_unstemmed Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study
title_short Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study
title_sort excess mortality in depressive and anxiety disorders: the lifelines cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8446070/
https://www.ncbi.nlm.nih.gov/pubmed/34462033
http://dx.doi.org/10.1192/j.eurpsy.2021.2229
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