Associations between midlife chronic conditions and medication use with anxiety and depression: A cross-sectional analysis of the PREVENT Dementia study.

Journal of comorbidity Pub Date : 2020-05-05 eCollection Date: 2020-01-01 DOI:10.1177/2235042X20920443
Lucy E Stirland, Sarah Gregory, Tom C Russ, Craig W Ritchie, Graciela Muniz-Terrera
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Abstract

Background: Multimorbidity including physical and mental illness is increasing in prevalence. We aimed to investigate the associations between physical conditions and medication use with anxiety and depression in midlife.

Methods: We conducted an observational cross-sectional study of volunteers in the PREVENT Dementia study. Using logistic and linear regression, we investigated the association between increasing numbers of self-reported chronic physical conditions and medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest.

Results: Of the 210 participants, 148 (71%) were women and 188 (90%) Caucasian. The mean age was 52 (standard deviation (SD) = 5.5) years. The mean number of physical conditions was 2.2 (SD = 1.9) and medications 1.7 (SD = 2.2). Each additional physical condition was associated with increased odds of self-reported depression (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.11-1.80; p = 0.004, adjusted for age and gender) and anxiety disorder (OR 1.70, 95% CI 1.30-2.37; p < 0.001). Increasing medication use was associated with self-reported depression (adjusted OR per additional medication 1.35, 95% CI 1.08-1.71; p = 0.008) but not anxiety disorder. For each additional condition, CES-D scores increased by 0.72 (95% CI 0.11-1.33; p = 0.020) and for each extra medication, by 0.88 (95% CI 0.32-1.44; p = 0.002). There was no significant association between increasing conditions and medications with STAI scores. In models accounting for antidepressant use, all associations were attenuated.

Conclusions: Having more physical conditions is associated with anxiety and depression in midlife, and taking more medications is associated with depression but not anxiety.

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中年慢性疾病和药物使用与焦虑和抑郁之间的关系:预防痴呆研究的横断面分析
背景:包括身体和精神疾病在内的多病患病率正在上升。我们的目的是调查身体状况和药物使用与中年焦虑和抑郁之间的关系。方法:我们在预防痴呆研究中对志愿者进行了一项观察性横断面研究。采用logistic回归和线性回归的方法,研究了自我报告的慢性身体状况和药物与自我报告的抑郁和焦虑障碍数量的增加,以及流行病学研究中心抑郁(CES-D)量表和Spielberger状态-特质焦虑量表(STAI)状态子测试的得分之间的关系。结果:210名参与者中,女性148人(71%),白种人188人(90%)。平均年龄52岁(标准差(SD) = 5.5)。身体状况的平均次数为2.2 (SD = 1.9),药物治疗的平均次数为1.7 (SD = 2.2)。每一种额外的身体状况都与自我报告抑郁的几率增加相关(优势比(OR) 1.41, 95%可信区间(CI) 1.11-1.80;p = 0.004,经年龄和性别校正)和焦虑障碍(OR 1.70, 95% CI 1.30-2.37;p 0.001)。增加用药与自我报告的抑郁相关(每增加用药调整OR 1.35, 95% CI 1.08-1.71;P = 0.008),而非焦虑障碍。每增加一种情况,CES-D评分增加0.72 (95% CI 0.11-1.33;p = 0.020),每增加一种药物,增加0.88 (95% CI 0.32-1.44;P = 0.002)。加重病情和药物与STAI评分之间没有显著的关联。在考虑抗抑郁药使用的模型中,所有关联都减弱了。结论:身体状况较多与中年焦虑、抑郁相关,服药较多与抑郁相关,与焦虑无关。
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