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Increased mortality among people with anxiety disorders: total population study
Sandra M Meier1, Manuel Mattheisen2, Ole Mors2
1Sandra M. Meier, PhD, National Centre for Register-Based Research, Aarhus University, Aarhus, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, and Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Manuel Mattheisen, MD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, and Department of Biomedicine, Aarhus University, Aarhus, Denmark; Ole Mors, PhD, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, and Research Department P, Aarhus University Hospital, Risskov, Denmark; Preben B. Mortensen, DrMedSc, National Centre for Register-Based Research, Aarhus University, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Thomas M. Laursen, PhD, National Centre for Register-Based Research, Aarhus University, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Brenda W. Penninx, PhD, Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands smeier@econ.au.dk.
Background:
Anxiety disorders and depression are the most common mental disorders worldwide and have a striking impact on global disease burden. Although depression has consistently been found to increase mortality; the role of anxiety disorders in predicting mortality risk is unclear.
Aims:
To assess mortality risk in people with anxiety disorders.
Method:
We used nationwide Danish register data to conduct a prospective cohort study with over 30 million person-years of follow-up.
Results:
In total, 1066 (2.1%) people with anxiety disorders died during an average follow-up of 9.7 years. The risk of death by natural and unnatural causes was significantly higher among individuals with anxiety disorders (natural mortality rate ratio (MRR) = 1.39, 95% CI 1.28-1.51; unnatural MRR = 2.46, 95% CI 2.20-2.73) compared with the general population. Of those who died from unnatural causes, 16.5% had comorbid diagnoses of depression (MRR = 11.72, 95% CI 10.11-13.51).
Conclusions:
Anxiety disorders significantly increased mortality risk. Comorbidity of anxiety disorders and depression played an important part in the increased mortality.
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