title: Excess mortality due to depression and anxiety in the United States: results from a nationally representative survey.
abstract: OBJECTIVE
  We compared the mortality of persons with and without anxiety and depression in a nationally representative survey and examined the role of socioeconomic factors, chronic diseases and health behaviors in explaining excess mortality.
  
  
  METHODS
  The 1999 National Health Interview Survey was linked with mortality data through 2011. We calculated the hazard ratio (HR) for mortality by presence or absence of anxiety/depression and evaluated potential mediators. We calculated the population attributable risk of mortality for anxiety/depression.
  
  
  RESULTS
  Persons with anxiety/depression died 7.9 years earlier than other persons. At a population level, 3.5% of deaths were attributable to anxiety/depression. Adjusting for demographic factors, anxiety/depression was associated with an elevated risk of mortality [HR=1.61, 95% confidence interval (CI)=1.40, 1.84]. Chronic diseases and health behaviors explained much of the elevated risk. Adjusting for demographic factors, people with past-year contact with a mental health professional did not demonstrate excess mortality associated with anxiety/depression while those without contact did.
  
  
  CONCLUSIONS
  Anxiety/depression presents a mortality burden at both individual and population levels. Our findings are consistent with targeting health behaviors and physical illnesses as strategies for reducing this excess mortality among people with anxiety/depression.
authors.affiliation: Centers for Disease Control and Prevention/National Center for Health Statistics, 3311 Toledo Road, Room 6333, Hyattsville, MD 20782, USA. Electronic address: lpratt@cdc.gov.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Pratt
authors.affiliation: Department of Health Policy and Management, Center for Behavioral Health Policy Studies, Rollins School of Public Health, 1518 Clifton Road, NE, Room 638, Atlanta, GA 30322, USA. Electronic address: bdruss@emory.edu.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Druss
authors.affiliation: National Association of County Behavioral Health and Developmental Disability Directors, 25 Massachusetts Avenue, NW, Suite 500, Washington, DC 20001, USA. Electronic address: rmanderscheid@nacbhd.org.
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Manderscheid
authors.affiliation: Department of Health Policy and Management, Center for Behavioral Health Policy Studies, Rollins School of Public Health, 1518 Clifton Road, NE, Room 638, Atlanta, GA 30322, USA. Electronic address: ereisin@emory.edu.
authors.forename: Elizabeth Reisinger
authors.initials: ER
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000401:mortality; D002908:Chronic Disease / Q000453:epidemiology* / Q000401:mortality; D003866:Depressive Disorder / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Anxiety; Depression; Mental health; Mortality; NHIS