title: Prevalence of distress, comorbid conditions and well being in the general population.
abstract: BACKGROUND
  The purposes of this paper are to determine the prevalence of distress in the community, to identify its determinants and to assess its relationship to somatic conditions and subjective well being.
  
  
  METHODS
  Distress and associated factors were investigated in a random sample of 5000 participants (35-74 years) of a community-based, prospective, observational cohort study in western Mid-Germany ("Gutenberg Heart Study") between 04/2007 and 10/2008. The sample was stratified 1:1 for gender and residence and in equal strata for decades of age. Data were assessed by self-report instruments, interviews and medical examination.
  
  
  RESULTS
  We found a prevalence rate for depression of 7.2% (6.5-8.0%), social anxiety 7.0% (6.3-7.7%), panic 4.6% (4.0-5.2%), generalized anxiety 3.4% (2.9-3.9%), and Type D personality 22.1% (21.0-23.2%). Mental conditions declined by age. Depression was related to diabetes (OR=1.99, 95% CI=1.26-3.15), dyslipidemia (OR=1.35, 95% CI=1.02-1.79), coronary heart disease (CHD; OR=1.88, 95% CI=1.04-3.39), and the history of stroke (OR=2.43, 95% CI=1.02-5.76). Panic was related to the history of myocardial infarction (OR=2.46, 95% CI=1.15-5.25), and generalized anxiety to obesity (OR=1.65, 95% CI=1.11-2.44). Mental distress was unrelated to hypertension, atrial fibrillation and cancer. In ordinal logistic regression subjective physical and mental well being were associated with anxiety, depression and Type D personality.
  
  
  CONCLUSIONS
  While mental conditions are highly prevalent, especially depression is associated with several somatic conditions. Mental and physical well being are strongly related to mental conditions. Future work should take into account comorbid conditions when identifying the impact of depression on CHD.
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany. joerg.wiltink@unimedizin-mainz.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Till
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Ojeda
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.forename: Matthias
authors.initials: M
authors.lastname: Michal
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D016584:Panic Disorder / Q000453:epidemiology; D010554:Personality Disorders / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology