Anxiety association with physical health problems

U of M research study finds new link in health problems

CHRISTINE LEONG VOLUNTEER STAFF

A recent study at the University of Manitoba has found a link between anxiety disorders and physical health problems. Led by Dr. Jitender Sareen, the study found that the presence of both anxiety and physical health problems increased the chance of disability and decreased quality of life.

The study was published in Archives of Internal Medicine on Oct. 23, 2006.

“Anxiety disorders independently have a huge cost on society,” said Sareen.

According to the study, the presence of an anxiety disorder was significantly associated with thyroid disease, respiratory disease, gastrointestinal disease, arthritis, migraine headaches, and allergic conditions.

Sareen mentioned that migraine headaches are a common physical condition associated with anxiety in the young. He added that those in their “20s and 30s were very strongly associated with anxiety problems.”

“Anxiety usually has a tendency to have an onset by adolescence to young adulthood,” said Sareen. “The young, especially if they have asthma, migraine, gastrointestinal problems or chronic pain, are more at risk of having an anxiety problem.”

The study involved 4,181 adults (1,913 men and 2,268 women) that were a part of the German Health Survey (GHS) conducted between 1997 and 1999. The participants were between the ages of 18 and 65 and were assessed for the presence of anxiety disorders including panic disorder, agoraphobia, social phobia, and obsessive-compulsive disorder.

“Panic disorder is the most severe of the disorders and often has the most physical symptoms, due in part to chemical release into the body and the mind always preparing for the next attack,” mentioned Bruce Sielski of the Anxiety Disorders Association of Manitoba (ADAM).

Among the participants, 8.4 per cent had an anxiety disorder within the past month and 60.8 per cent had a physical condition within the past month. Compared with physical disorders alone, those with anxiety plus one or more physical conditions were associated with poorer physical health scores.

Notably, 18.2 per cent of those with an anxiety disorder had a gastrointestinal disease (including gastritis and ulcers) and about 20 per cent had migraine headaches. The most shocking finding, according to Sareen, was that cardiac disease was not found to be associated with anxiety problems. Only 13 per cent of the participants with anxiety had a cardiac disease compared with 8.3 per cent of those with an anxiety disorder but showed no presence of a cardiac event.

“It’s well-known that cardiac disease is associated with anxiety problems,” said Sareen. “The reason we think that it was [not associated] was because of the low prevalence of cardiac disease in that age range of our participants. We still think that cardiac is associated.”

The study noted the importance in recognizing and treating depression in general practice and that such efforts have improved in the last 10 years.

“In primary care, or even in cardiology and respiratory medicine, there is more awareness that when someone has depression, that might affect their physical health and they might be less likely to be adherent to their medication,” said Sareen. “We don’t have data on this yet, but improving the anxiety problem may have a secondary affect on improving the physical health problem.”

According to the most recent data from Statistics Canada, there are about twice as many females than males that feel depressed between the ages of 18 and 24. The gap decreases between the ages of 25 and 34 years old at 110,000 males and 184,000 females.

“Depends on how you look at anxiety, but as far as having one or more anxiety disorders, at some point in a person’s life, one in five people will have an anxiety problem. In the past year it was more like one in 10,” noted Sareen. “Women were more likely to have an anxiety problem for most of the anxiety disorders than men, except for obsessive-compulsive disorder, which seems to be equal in men and women.”

In addition to this, Sareen asserted, “100 per cent of us have anxiety” at some point in life.

“When it becomes a disorder is when a person does things to avoid anxious situations in a repeated pattern,” said Sareen.

Sareen hopes that these findings will encourage people who are experiencing anxiety problems to seek help as soon as possible.

“Right now there is a long delay between someone developing an anxiety problem and seeking appropriate treatment — usually 10- 15 years,” said Sareen. “The hope is to get people with anxiety problems to go get help earlier. The treatments are quite effective if you get at it early before you get secondary [health conditions].”