title: Depression and anxiety disorders and the link to physician diagnosed cardiac disease and metabolic risk factors.
abstract: OBJECTIVE
  There has been increasing interest in the relationship between cardiac and metabolic conditions with mental illness. Many studies have found associations between these conditions and depression but results with anxiety disorders have been mixed. We explore these relationships in a nationally representative survey using physician diagnoses of physical conditions and DSM-IV psychiatric disorders.
  
  
  METHODS
  Data came from the nationally representative German Health Survey (N=4181, age 18-65). Physician diagnoses of angina, myocardial infarction, congestive heart, hypertension, dyslipidemia, diabetes, and obesity were examined in relation to depression and anxiety disorders, which were assessed through a modified version of the Composite International Diagnostic Interview. Multiple logistic regression analyses were used to examine the associations between these conditions.
  
  
  RESULTS
  After adjusting for sociodemographics, psychiatric comorbidity, and substance use, having an anxiety disorder was associated with increased odds of cardiac conditions and metabolic risk factors with odds ratios ranging from 1.3 to 3.3. Depression was not associated with any of the conditions but was associated with poor medical compliance for health conditions on two outcomes measured. Anxiety was also associated with reduced medical compliance for one health behaviour measured.
  
  
  CONCLUSIONS
  Anxiety disorders, but not depression, were associated with metabolic and cardiac conditions in our sample. Both conditions were related to some aspects of poor self-care for health conditions and therefore may be linked to negative outcomes.
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: D Jolene
authors.initials: DJ
authors.lastname: Kinley
authors.affiliation: Department of Psychiatry, University of Saskatchewan, Saskatoon, Saschetchewan, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Lowry
authors.affiliation: Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Cara
authors.initials: C
authors.lastname: Katz
authors.affiliation: Department of Psychology, Technical University of Dresden, Dresden, Saxony, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Jacobi
authors.affiliation: Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Davinder S
authors.initials: DS
authors.lastname: Jassal
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: sareen@cc.umanitoba.ca.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology*; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: Anxiety; Cardiac disease; Depression; Epidemiology; Metabolic risk factors