Depressive symptoms linked to higher mortality in adults

TOP LINE:

There is a graded positive association between depressive symptoms and mortality among adults, a finding that researchers say supports the development of a comprehensive national strategy to improve mental and physical health.

METHODOLOGY:

• Researchers analyzed data from 23,694 adults (mean age, 44 years; 50% men) from the National Health and Nutrition Examination Survey from 2005 to 2018, linked to mortality data through 2019.

• Depressive symptoms were assessed using Patient Health Questionnaire-9 scores and were categorized as none/minimal, mild, and moderate to severe.

• The primary outcomes were all-cause mortality, cardiovascular disease (CVD), and ischemic heart disease (IHD).

• Analyzes were adjusted for demographics, health factors, and lifestyle variables.

TAKE AWAY:

• The prevalence of mild depression and moderate to severe depression was 14.9% and 7.2%, respectively.

• Compared with no or minimal depressive symptoms, the risk of all-cause mortality and cardiovascular mortality was 35% higher and 49% higher, respectively, among those with mild depressive symptoms and 62% higher and 79% higher, respectively. respectively, in those with moderate to severe depressive symptoms. depressive symptoms.

• Moderate to severe (but not mild) depressive symptoms were also associated with more than two times higher risk of IHD mortality.

• About 11% to 16% of the associations between depression and mortality could be explained by lifestyle factors.

IN PRACTICE:

“Together with the body of literature on associations between depression and cardiovascular disease mortality, these findings can support public health efforts to develop a comprehensive, nationwide strategy to improve well-being, including mental and cardiovascular health,” the authors write.

SOURCE:

The study, led by first author Zefeng Zhang, MD, PhD, of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, was published online Oct. 9 in Open JAMA Network.

BOUNDARIES:

Depressive symptoms were measured only at baseline, so investigators were not able to account for changes in depressive symptoms over time. Potential effects of unmeasured confounders, such as anxiety disorder, general stress, and work-related stress, cannot be completely excluded, so the association between depression and mortality might be overestimated.

DISCLOSURES:

The study was funded by the CDC. The authors reported no conflicts of interest.

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