Association between Early-Onset Metabolic Diseases and Adverse Mental Health Conditions: A Nationwide Cross-Sectional...

Though metabolic diseases increasingly affect younger populations, their mental health implications remain poorly understood. We examined associations between age at metabolic disease diagnosis and mental health conditions, comparing early-onset (age <40 years) and late-onset (age ≥40 years) cases.

We analyzed the 2014-2023 Korea National Health and Nutrition Examination Survey. Participants reported physician-diagnosed hypertension, diabetes, or dyslipidemia, with age at diagnosis. Mental health conditions included depression, perceived stress, and suicidality. Depression was assessed using the Patient Health Questionnaire-9, perceived stress through self-reported daily experiences, and suicidality as the presence of suicidal ideation, planning, or attempts within the past year. Associations were examined using multiple logistic regression with Bonferroni correction.

Early-onset hypertension [odds ratio (OR)=2.67; 95% confidence interval (CI): 1.91-3.74] and dyslipidemia (OR=2.55; 95% CI: 1.71-3.79) showed higher odds of depression compared to undiagnosed and late-onset cases (p-diff.<0.001 and p-diff.=0.001, respectively). Early-onset hypertension (OR=1.41; 95% CI: 1.21-1.66) and dyslipidemia (OR=1.90; 95% CI: 1.59-2.26) showed higher odds of perceived stress compared to undiagnosed and late-onset cases (both p-diff.<0.001). Early-onset diabetes (OR=2.76; 95% CI: 1.79-4.25) showed higher odds of suicidality compared to undiagnosed and late-onset cases (p-diff.<0.001).

Early-onset metabolic diseases showed stronger associations with adverse mental health conditions than late-onset cases, with patterns suggesting these associations were not primarily explained by disease duration. While the cross-sectional design limits causal inference, mental health screening in early-onset metabolic disease care could be considered.