title: Hemoglobin levels in persons with depressive and/or anxiety disorders.
abstract: OBJECTIVE
  Both low and high hemoglobin levels lead to more physical diseases, and both are linked to mortality. Low hemoglobin, often classified as anemia, has also been linked to more depressive symptoms, but whether both hemoglobin extremes are associated with depressive disorder and potentially also with anxiety disorder has not been examined before. This study examines to which extent hemoglobin levels are associated with depression and anxiety disorders in a large cohort.
  
  
  METHODS
  The study sample consisted of 2920 persons from the Netherlands Study of Depression and Anxiety. Hemoglobin levels were determined after venipuncture. Depressive and anxiety disorders were determined according to a DSM-IV-based psychiatric interview. Clinical psychiatric characteristics included the severity of depression and anxiety, the duration of symptoms, the age of onset and the antidepressant use.
  
  
  RESULTS
  Higher hemoglobin levels were found in those with current depressive and/or anxiety disorders after sociodemographic adjustment and both higher, and lower hemoglobin levels were found in persons with higher depression and anxiety severity. However, after full adjustment for sociodemographics, disease indicators and lifestyle, associations were no longer significant.
  
  
  CONCLUSIONS
  This cohort study showed that there is no independent association between depressive and/or anxiety disorders and hemoglobin levels or anemia status.
authors.affiliation: Department of Psychiatry, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: b.lever@ggzingeest.nl.
authors.forename: Bianca A
authors.initials: BA
authors.lastname: Lever-van Milligen
authors.affiliation: Department of Psychiatry, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Vogelzangs
authors.affiliation: Department of Psychiatry, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Smit
authors.affiliation: Department of Psychiatry, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D017668:Age of Onset; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000097:blood / Q000175:diagnosis; D001008:Anxiety Disorders / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D015331:Cohort Studies; D003863:Depression / Q000097:blood / Q000175:diagnosis; D003866:Depressive Disorder / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012720:Severity of Illness Index
chemical_list: D000928:Antidepressive Agents; D006454:Hemoglobins
keywords: Anemia; Anxiety; Depression; Hemoglobin