title: Social and psychological predictors of onset of anxiety disorders: results from a large prospective cohort study.
abstract: OBJECTIVE
  The vast majority of studies investigating the association between social and psychological factors and anxiety disorders have been cross-sectional, making it difficult to draw causal conclusions. The purpose of the study was to investigate in a prospective longitudinal study whether social and psychological factors are associated with the later risk of being admitted to a hospital and receive a diagnosis of anxiety disorders.
  
  
  METHODS
  The study population comprised 4,497 members of The Copenhagen Perinatal Cohort (CPC) who in 1993 answered a mailed questionnaire containing questions on a range of social and psychological factors. In 2007, the study population was linked to The Danish Hospital Discharge Register and the Danish Psychiatric Central Register to obtain information on registration with anxiety disorders. Multiple Cox regression analysis was used to analyze the risk of anxiety disorders according to social and psychological factors.
  
  
  RESULTS
  A total of 5.3% of the study population had lifetime registration with an anxiety disorder diagnosis. The risk of admission for anxiety disorders was significantly associated with previous: discontentedness with partner-status, loneliness, self-rated low intelligence, not feeling part of a whole, unhappiness, low quality of life, and low meaningfulness. Estimates were adjusted for income and current diseases.
  
  
  CONCLUSIONS
  The present study demonstrated that in a population without previous registration with anxiety disorders, contentment with social relations and a range of beneficial psychological factors reduced the later risk of being hospitalized with anxiety disorders.
authors.affiliation: Research Programme on Lifestyle and Health, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5 1353, Copenhagen, Denmark. tfm@niph.dk
authors.forename: Trine
authors.initials: T
authors.lastname: Flensborg-Madsen
authors.forename: Janne
authors.initials: J
authors.lastname: Tolstrup
authors.forename: Holger Jelling
authors.initials: HJ
authors.lastname: Sørensen
authors.forename: Erik Lykke
authors.initials: EL
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D003718:Denmark / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012649:Self Concept; D012747:Sexual Partners / Q000523:psychology; D012919:Social Behavior; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires