Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions.
BACKGROUND
Evidence has been emerging that anxiety disorders are associated with several physical health conditions. We used the first community survey, which assessed physical conditions based on physician assessment and included standardized diagnostic assessment of mental disorders by trained health professionals, to examine the relationship between anxiety disorders and physical conditions.


METHODS
The German Health Survey (N = 4181; response rate, 87.6%; ages 18-65 years) used the Composite International Diagnostic Interview to assess Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mood, substance use, and anxiety disorders (panic disorder, social phobia, specific phobia, generalized anxiety disorder, agoraphobia, obsessive-compulsive disorder) and a standardized medical interview supplemented by laboratory data to assess a broad range of physical conditions. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used to measure health-related quality of life. Number of days of role impairment was used to measure past 30-day disability.


RESULTS
After adjusting for sociodemographic factors and other common mental disorders, the presence of an anxiety disorder was significantly associated with thyroid disease, respiratory disease, gastrointestinal disease, arthritis, migraine headaches, and allergic conditions (adjusted odds ratios between 1.39 and 2.12; P<.05). Compared with physical disorders alone, the presence of comorbid anxiety disorder with 1 or more physical disorders was associated with poorer physical component scores on the SF-36 (adjusted mean scores for physical condition alone and physical condition with anxiety disorder, 48.50 and 45.86, respectively; P<.001) and past 30-day disability due to physical problems (adjusted odds ratio, 1.69; 95% confidence interval, 1.20-2.37).


CONCLUSIONS
Anxiety disorders are independently associated with several physical conditions in the community, and this comorbidity is significantly associated with poor quality of life and disability.
Sareen
Jitender
J
Department of Psychiatry and Community Health Sciences, University of Manitoba, Winnipeg, Canada. sareen@cc.umanitoba.ca
Jacobi
Frank
F
Cox
Brian J
BJ
Belik
Shay-Lee
SL
Clara
Ian
I
Stein
Murray B
MB
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis