Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health Surveys

J Affect Disord. 2007 Nov;103(1-3):113-20. doi: 10.1016/j.jad.2007.01.015. Epub 2007 Feb 9.


Background: Prior research on the association between affective disorders and physical conditions has been carried out in developed countries, usually in clinical populations, on a limited range of mental disorders and physical conditions, and has seldom taken into account the comorbidity between depressive and anxiety disorders.

Methods: Eighteen general population surveys were carried out among adults in 17 countries as part of the World Mental Health Surveys initiative (N=42, 249). DSM-IV depressive and anxiety disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions were ascertained via a standard checklist. The relationship between mental disorders and physical conditions was assessed by considering depressive and anxiety disorders independently (depression without anxiety; anxiety without depression) and conjointly (depression plus anxiety).

Results: All physical conditions were significantly associated with depressive and/or anxiety disorders but there was variation in the strength of association (ORs 1.2-4.5). Non-comorbid depressive and anxiety disorders were associated in equal degree with physical conditions. Comorbid depressive-anxiety disorder was more strongly associated with several physical conditions than were single mental disorders.

Limitations: Physical conditions were ascertained via self report, though for a number of conditions this was self-report of diagnosis by a physician.

Conclusions: Given the prevalence and clinical consequences of the co-occurrence of mental and physical disorders, attention to their comorbidity should remain a clinical and research priority.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Chronic Disease / epidemiology*
  • Chronic Disease / psychology
  • Comorbidity
  • Cross-Cultural Comparison
  • Cross-Sectional Studies
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology
  • Dysthymic Disorder / diagnosis
  • Dysthymic Disorder / epidemiology*
  • Dysthymic Disorder / psychology
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Sick Role