Mortality in relation to self-reported mixed anxiety and depression symptoms--The HUNT study

Excess mortality in anxiety and depression has mostly been studied for diagnostic categories of each condition separately. The aim of this article is to study the association between self-reported mixed anxiety and depression and mortality in the general population. A population survey of 2624 individuals was defined in three groups according to their total score on Hospital Anxiety and Depression rating Scale (HADS-T): 0-19 points, 19-24 points and 25 points or above; 114 deaths (4.3%) occurred during 4.5 years. Only the highest score group had increased mortality risk after adjustment for all relevant confounding factors (P=0.043). However, trend tests supported a dose-response relationship between increasing HADS-T score and increasing total mortality across the three groups (P for trend = 0.02). All seven suicides occurred in cases detected by HADS-T (>or=19 points) at baseline. Our sample is limited and the findings therefore tentative, yet there seems to a positive correlation between HADS-T symptom level and total mortality risk in a 4.5-year perspective.