The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults.
OBJECTIVE
The aim of this study was to examine the extent to which depression and anxiety are associated with smoking, obesity, physical inactivity and alcohol consumption in the US population using the Patient Health Questionnaire 8 (PHQ-8) and two questions on lifetime diagnosis of anxiety and depression.


METHODS
Data were analyzed in 38 states, the District of Columbia and two territories using the 2006 Behavioral Risk Factor Surveillance System (n=217,379), a large state-based telephone survey.


RESULTS
Overall, adults with current depression or a lifetime diagnosis of depression or anxiety were significantly more likely than those without each diagnosis to smoke, to be obese, to be physically inactive, to binge drink and drink heavily. There was a dose-response relationship between depression severity and the prevalence of smoking, obesity and physical inactivity and between history of depression (never depressed, previously depressed, currently depressed) and the prevalence of smoking, obesity, physical inactivity, binge drinking and heavy drinking. Lifetime diagnosis of depression and anxiety had an additive association with smoking prevalence.


CONCLUSIONS
The associations between depression, anxiety, obesity and unhealthy behaviors among US adults suggest the need for a multidimensional and integrative approach to health care.
Strine
Tara W
TW
Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. tws2@cdc.gov
Mokdad
Ali H
AH
Dube
Shanta R
SR
Balluz
Lina S
LS
Gonzalez
Olinda
O
Berry
Joyce T
JT
Manderscheid
Ron
R
Kroenke
Kurt
K
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D001007:Anxiety / Q000453:epidemiology*; D040343:Behavioral Risk Factor Surveillance System; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000523:psychology*; D014481:United States / Q000453:epidemiology