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Longitudinal bidirectional associations between internalizing mental disorders and cardiometabolic disorders in the

Jasper Nuyen¹, Elisabeth H Bos², Peter de Jonge²

¹Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands. jnuijen@trimbos.nl.

Social Psychiatry and Psychiatric Epidemiology

|January 5, 2021

Insights

Internalizing mental disorders (INT) increase the risk of cardiometabolic disorders (CM) in the short term. Cardiometabolic disorders may increase the likelihood of developing internalizing disorders over longer periods.

Area of Science:

Epidemiology
Psychiatry
Cardiology

Background:

Mental health disorders and cardiometabolic disorders represent significant public health challenges.
Understanding the bidirectional relationship between these conditions is crucial for effective prevention and treatment strategies.

Purpose of the Study:

To investigate the association between internalizing mental disorders (INT) and cardiometabolic disorders (CM) over 3, 6, and 9-year intervals.
To examine the relationship in both directions: INT predicting CM, and CM predicting INT.

Main Methods:

Prospective population-based study using data from the Netherlands Mental Health Survey and Incidence Study-2.
Assessed presence and onset of INT (mood/anxiety disorders) and CM (hypertension, diabetes, heart disease, stroke) using standardized diagnostic interviews and self-report.
Employed multilevel logistic autoregressive models, controlling for covariates and previous wave outcomes.

Main Results:

Internalizing disorders significantly predicted the presence (OR 1.28) and onset (OR 1.46) of cardiometabolic disorders at 3-year follow-up.
Cardiometabolic disorders did not significantly predict the presence of INT at 3 years.
A borderline significant association was found for CM predicting the onset of INT over 6-year intervals (OR 1.64).

Conclusions:

Internalizing mental disorders are a significant risk factor for developing cardiometabolic disorders in the short term.
Cardiometabolic disorders may contribute to the onset of internalizing mental disorders over longer time frames.
Further research is warranted to elucidate the underlying mechanisms of these associations.

Read full analysis

Abstract

Purpose:

This prospective population-based study investigated whether having any internalizing mental disorder (INT) was associated with the presence and onset of any cardiometabolic disorder (CM) at 3-year follow-up; and vice versa. Furthermore, we examined whether observed associations differed when using longer time intervals of respectively 6 and 9 years.

Methods:

Data were used from the four waves (baseline and 3-, 6- and 9-year follow-up) of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults. At each wave, the presence and first onset of INT (i.e. any mood or anxiety disorder) were assessed with the Composite International Diagnostic Interview 3.0; the presence and onset of CM (i.e. hypertension, diabetes, heart disease, and stroke) were based on self-report. Multilevel logistic autoregressive models were controlled for previous-wave INT and CM, respectively, and sociodemographic, clinical, and lifestyle covariates.

Results:

Having any INT predicted both the presence (OR 1.28, p = 0.029) and the onset (OR 1.46, p = 0.003) of any CM at the next wave (3-year intervals). Having any CM was not significantly related to the presence of any INT at 3-year follow-up, while its association with the first onset of any INT reached borderline significance (OR 1.64, p = 0.06), but only when examining 6-year intervals.

Conclusions:

Our findings indicate that INTs increase the risk of both the presence and the onset of CMs in the short term, while CMs may increase the likelihood of the first onset of INTs in the longer term. Further research is needed to better understand the mechanisms underlying the observed associations.

Keywords:

Adult general population Cardiometabolic disorders Internalizing mental disorders Prospective cohort study

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