title: Associations between mental disorders and subsequent onset of hypertension.
abstract: BACKGROUND
  Previous work has suggested significant associations between various psychological symptoms (e.g., depression, anxiety, anger, alcohol abuse) and hypertension. However, the presence and extent of associations between common mental disorders and subsequent adult onset of hypertension remain unclear. Further, there are few data available on how such associations vary by gender or over life course.
  
  
  METHODS
  Data from the World Mental Health Surveys (comprising 19 countries and 52,095 adults) were used. Survival analyses estimated associations between first onset of common mental disorders and subsequent onset of hypertension, with and without psychiatric comorbidity adjustment. Variations in the strength of associations by gender and by life course stage of onset of both the mental disorder and hypertension were investigated.
  
  
  RESULTS
  After psychiatric comorbidity adjustment, depression, panic disorder, social phobia, specific phobia, binge eating disorder, bulimia nervosa, alcohol abuse and drug abuse were significantly associated with subsequent diagnosis of hypertension (with odds ratios ranging from 1.1 to 1.6). Number of lifetime mental disorders was associated with subsequent hypertension in a dose-response fashion. For social phobia and alcohol abuse, associations with hypertension were stronger for males than females. For panic disorder, the association with hypertension was particularly apparent in earlier-onset hypertension.
  
  
  CONCLUSIONS
  Depression, anxiety, impulsive eating disorders and substance use disorders were significantly associated with the subsequent diagnosis of hypertension. These data underscore the importance of early detection of mental disorders, and of physical health monitoring in people with these conditions.
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Electronic address: dan.stein@uct.ac.za.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: University of California, Davis, Center for Reducing Health Disparities, School of Medicine, Sacramento, CA, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.affiliation: Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.affiliation: Institute of Mental Health, Peking University, Beijing, PR China.
authors.forename: Zharoui
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Jose
authors.initials: J
authors.lastname: Miguel Caldas-de-Almeida
authors.affiliation: Psychology Research Institute, University of Ulster, Londonderry, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Neill
authors.affiliation: Department of Social Medicine, Federal University of Espırito Santo (UFES), Vitoria, Brazil.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.affiliation: Al-Qadisiya University, College of Medicine, Diwania Governorate, Iraq.
authors.forename: Ali Obaid
authors.initials: AO
authors.lastname: Al-Hamzawi
authors.affiliation: Center for Public Mental Health, Gosing am Wagram, Austria.
authors.forename: Mattias C
authors.initials: MC
authors.lastname: Angermeyer
authors.affiliation: Instituto Nacional de Psiquiatria Ramon de la Fuente, Mexico City, Mexico.
authors.forename: Corina
authors.initials: C
authors.lastname: Benjet
authors.affiliation: Department of Mental Health, School of Public Health; Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.affiliation: Bamford Centre for Mental Health and Wellbeing MRC Trial Methodology Hub, University of Ulster, Londonderry, UK.
authors.forename: Finola
authors.initials: F
authors.lastname: Ferry
authors.affiliation: Department of Epidémiologie et Biostastistiques EHESP, and Paris Descartes University Research Unit EHESP, School for Public Health Dept of Epidemiology and Biostatistics.
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
authors.affiliation: Research & Planning, Mental Health Services Ministry of Health, Jerusalem, Israel.
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.affiliation: IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.affiliation: Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China.
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.affiliation: The University of Tokyo, Tokyo, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.affiliation: Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Maria Haro
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Marina
authors.initials: M
authors.lastname: Piazza
authors.affiliation: Colegio Mayor de Cundinamarca University, Bogota, DC, Colombia.
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.affiliation: Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Bogdan J
authors.initials: BJ
authors.lastname: Wojtyniak
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Xavier
authors.affiliation: Department of Psychological Medicine, Otago University, Dunedin, New Zealand.
authors.forename: Carmen C W
authors.initials: CC
authors.lastname: Lim
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Department of Psychological Medicine, Otago University, Dunedin, New Zealand.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology; D015999:Multivariate Analysis; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D016019:Survival Analysis; D055815:Young Adult
keywords: Common mental disorders; Hypertension; World Mental Health Surveys