Several studies have indicated depression and anxiety to be associated with urinary incontinence (UI), however, the strength of the associations varies widely. The objective of this study was to determine these associations in a large survey.
In a cross-sectional population-based survey study, we analysed questionnaire data on UI, depression and anxiety from 5,321 women between 40 and 44 years. A multivariate logistic regression model was used to predict the odds of having high levels of anxiety and depression among women with UI of different types and severities.
Among women with UI, the adjusted OR for depression was 1.64 (95% CI, 1.32-2.04) and for anxiety 1.59 (95% CI, 1.36-1.86) compared with women without UI.
UI was associated with both anxiety and depression in middle-aged women, with the strongest associations for mixed and urgency UI.
Obesity is a problem that is increasing worldwide, leading to an increased incidence of type 2 diabetes mellitus (T2DM). Depression is more common among individuals with diabetes, and they are more likely than non-diabetic individuals to experience emotional problems. People with both T2DM and obesity bear an additional emotional burden, which affects their quality of life.
To describe the prevalence of symptoms of anxiety and depression in groups of obese and normal-weight individuals with T2DM who are undergoing primary care and to investigate possible differences between the groups and between genders.
Three hundred and thirty-nine patients with T2DM from nine primary-care centres participated in a cross-sectional study (n = 180 + 159). The response rate was 67%. The Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory - second edition (BDI-II) were employed to estimate the patients' symptoms of depression and anxiety.
An association between T2DM, obesity and depression was observed in both genders. More than one in three women and one in five men with T2DM and obesity exhibited symptoms of anxiety or depression. In the normal-weight group, the females presented more symptoms of anxiety than did their male counterparts.
In primary healthcare, the fact that both obese men and women with T2DM are at increased risk of anxiety and depression is an important finding, which must be recognised and considered in the course of primary healthcare consultations. Meeting the unique needs of each individual requires an understanding of both laboratory data and the individual's emotional status.
To examine whether elevated anxiety and/or depressive symptoms are related to all-cause mortality in people with Type 2 diabetes, not using insulin.
948 participants in the community-wide Nord-Trøndelag Health Survey conducted during 1995-97 completed the Hospital Anxiety and Depression Scale with subscales of anxiety (HADS-A) and depression (HADS-D). Elevated symptoms were defined as HADS-A or HADS-D =8. Participants with type 2 diabetes, not using insulin, were followed until November 21, 2012 or death. Cox regression analyses were used to estimate associations between baseline elevated anxiety symptoms, elevated depressive symptoms and mortality, adjusting for sociodemographic factors, HbA1c, cardiovascular disease and microvascular complications.
At baseline, 8% (n = 77/948) reported elevated anxiety symptoms, 9% (n = 87/948) elevated depressive symptoms and 10% (n = 93/948) reported both. After a mean follow-up of 12 years (SD 5.1, range 0-17), 541 participants (57%) had died. Participants with elevated anxiety symptoms only had a decreased mortality risk (unadjusted HR 0.66, 95% CI 0.46-0.96). Adjustment for HbA1c attenuated this relation (HR 0.73, 95% CI 0.50-1.07). Those with elevated depression symptoms alone had an increased mortality risk (fully adjusted model HR 1.39, 95% CI 1.05-1.84). Having both elevated anxiety and depressive symptoms was not associated with increased mortality risk (adjusted HR 1.30, 95% CI 0.96-1.74).
Elevated depressive symptoms were associated with excess mortality risk in people with Type 2 diabetes not using insulin. No significant association with mortality was found among people with elevated anxiety symptoms. Having both elevated anxiety and depressive symptoms was not associated with mortality. The hypothesis that elevated levels of anxiety symptoms leads to behavior that counteracts the adverse health effects of Type 2 diabetes needs further investigation.
BACKGROUND & AIMS: The Rome III criteria for functional dyspepsia have been changed to include 2 distinct syndromes: postprandial distress syndrome and epigastric pain syndrome. We investigated risk factors for functional dyspepsia among the functional dyspepsia subgroups defined by the Rome III criteria. METHODS: We performed a cross-sectional population-based study in a primary care setting (the Kalixanda study). A random sample (n = 2860) of the adult population from 2 northern Swedish municipalities (n = 21,610) was surveyed using a validated postal questionnaire to assess gastrointestinal symptoms (response rate, 74.2%; n = 2122). A randomly selected subgroup (n = 1001) of responders was invited to undergo an esophagogastroduodenoscopy (participation rate, 73.3%) including biopsy specimen collection, Helicobacter pylori culture and serology, and symptom assessments. RESULTS: Of the 1001 subjects examined by endoscopy, 202 (20.2%; 95% confidence interval [CI], 17.7-22.7) were classified as having uninvestigated dyspepsia and 157 (15.7%; 95% CI, 13.4-18.0) as having functional dyspepsia. Major anxiety (Hospital Anxiety and Depression Scale score > or = 11) was associated with uninvestigated dyspepsia (odds ratio [OR], 3.01; 95% CI, 1.39-6.54), as was obesity (body mass index > or = 30 kg/m(2)) (OR, 1.86; 95% CI, 1.15-3.01). Major anxiety was associated with functional dyspepsia and postprandial distress syndrome (OR of 2.56 [95% CI, 1.06-6.19] and 4.35 [95% CI, 1.81-10.46], respectively), as was use of nonsteroidal anti-inflammatory drugs (OR, 2.49 [95% CI, 1.29-4.78] and 2.75 [95% CI, 1.38-5.50], respectively). Depression was not associated with any dyspepsia group. CONCLUSIONS: Anxiety but not depression is linked to uninvestigated dyspepsia, functional dyspepsia, and postprandial distress syndrome but not to epigastric pain syndrome.
Although highly effective in preventing arrhythmic death, patients receiving an implantable cardioverter defibrillator (ICD) may still experience psychological difficulties such as anxiety, depression, and reduced quality of life. The objectives of this study were to describe patient-reported outcomes among ICD patients: (1) compared to a matched healthy population, (2) compared by ICD indication, (3) factors predicting patient-reported outcomes, and (4) if patient-reported outcomes predicted mortality.
The study was a mailed survey to an unselected group of patients 18+ years old receiving ICD between January 1, 2011 and June 30, 2011 (n = 499). The following instruments were used: SF-36, Hospital Anxiety and Depression Scale, HeartQoL, EQ-5D, and the Multidimensional Fatigue Inventory.
The response rate was 72%. Mean age was 65.5 years and 82% patients were males. Fifty-three percent of patients had primary prevention indication ICD. Compared to an age- and gender-matched population without disease, the ICD population had worse mental health (55.0 vs 51.7 points) and physical health (52.6 vs 41.9 points). Patients with primary prevention indication had lower levels of perceived health, quality of life, and fatigue; for example, physical health 39.8 versus 44.3 points, compared to secondary prevention indication. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality, anxiety being the strongest with an adjusted odds ratio of 4.17 (1.49; 11.66).
Patients with primary prevention ICD had lower levels of perceived health, quality of life, and more fatigue. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality.
Psychiatric disorders may be risk factors for reduced bone mineral density (BMD). Longitudinal evidence is limited and this is yet to be examined among community-dwelling adults with anxiety. We aimed to investigate the cross-sectional and longitudinal relationships between anxiety and depressive symptoms and BMD.
This study examined data from the second Nord-Trondelag Health Study (1995-1997; 1194 men and 7842 women) and a follow-up conducted in 2001 (697 men and 2751 women). Symptomatology was ascertained using the Hospital Anxiety and Depression Scale and BMD was measured at the forearm using single-energy X-ray absorptiometry. Information on medication use and lifestyle was self-reported, and these, together with anthropometric measures were tested in multivariate analyses.
In men, adjusted BMD was 2.6% lower at the ultradistal forearm for those with depressive symptoms and 2.6% lower at the ultradistal and 2.0% lower at the distal forearm for those with anxiety symptoms. In women, adjusted BMD at the distal and ultradistal forearm was lower for heavier women with depressive symptoms but this relationship diminished with decreasing weight. Forearm BMD was similar for women with or without anxiety symptoms. Longitudinally, neither depressive nor anxiety symptoms were associated with bone loss over 4.6 years.
Findings cannot be generalised to other skeletal sites and a longer follow-up period may be necessary to detect differences in bone loss.
These results indicate that depressive and anxiety symptoms are cross-sectionally associated with reduced BMD. These findings provide further evidence to support monitoring BMD in individuals diagnosed with psychiatric illness.
Aim of the study was elucidation of association between prevalence of ischemic heart disease (IHD) with high levels of psychosocial risk factors in open male population aged 25-64 years. We examined a representative sample of men aged 25-64 years formed from electoral lists in one of administrative districts in Tyumen. In a framework of cardiological screening we studied prevalence of IHD and levels of psychosocial risk factors - personality anxiety and depression - using standard WHO questionnaire MONICA-psychosocial. IHD prevalence among men aged 25-64 years in Tyumen was 12.4%. Among men of this age high levels of psychosocial risk factors were more frequent - in men with IHD than in men without IHD. In men with high levels of psychosocial risk factors we observed increase of risk of development of acute (A)IHD. Increases of risk of AIHD and IHD in the presence of personal anxiety or depression were characteristic for age categories 55-64 and 45-64 years, respectively.
The aim of this study was to examine psychological factors in insomnia and the association between psychological mechanisms and nighttime and daytime symptoms.
A cross-sectional examination in the general population was used. The study sample consisted of 1890 participants from the general population. The participants completed a survey on nighttime and daytime symptoms, health outcomes, and psychological factors.
Relative to poor and normal sleepers, the insomnia group had higher scores on worry, beliefs, physiologic arousal, monitoring/attentional bias, and safety behaviors than the other two groups, and the poor sleepers exhibited a similar pattern relative to the normal sleepers. High total wake time was associated with more worry, physiologic arousal, and safety behaviors (26.3% variance), low sleep restoration with more worry, unhelpful beliefs, and monitoring/attentional bias (28.2% variance), and low sleep quality with higher scores on all the psychological mechanisms (35.8% variance). Elevated daytime symptoms were related to more unhelpful beliefs and monitoring/attentional bias (44.3% variance).
The findings indicate that psychological factors are linked to nighttime and daytime symptomatology in insomnia.
To investigate the associations of anxiety and depression symptoms with weight change and incident obesity in men and women.
We conducted a prospective cohort study using the Norwegian Nord-Trøndelag Health Study (HUNT).
The study cohort included 25?180 men and women, 19-55 years of age from the second survey of the HUNT (1995-1997).
Anxiety and depression symptoms were measured using the Hospital Anxiety and Depression Scale. Weight change was determined for the study period of an average 11 years. Incident obesity was new-onset obesity classified as having a body mass index of ?30.0?kg?m(2) at follow-up. The associations of anxiety or depression with weight change in kilograms (kg) was estimated using linear regression models. Risk ratios (RRs) for incident obesity associated with anxiety or depression were estimated using log-binomial regression.
In men, any anxiety or depression was associated with an average 0.81?kg (95% confidence interval (CI) 0.27-1.34) larger weight change after 11 years compared with those without such symptoms (mean weight change: 5.04 versus 4.24?kg). Women with any anxiety or depression had an average 0.98?kg (95% confidence interval (CI) 0.49-1.47) larger weight change compared with those without such symptoms (mean weight change: 5.02 versus 4.04?kg). Participants with any anxiety or depression had a significantly elevated cumulative incidence of obesity (men: RR 1.37, 95% CI 1.13-1.65; women: RR 1.18, 95% CI 1.00-1.40).
We found that symptoms of anxiety and depression were associated with larger weight change and an increased cumulative incidence of obesity in both men and women.