Depression, anxiety disorders, and substance abuse are linked with — and often precede — a broad range of physical ailments, according to the first study of its kind.

Using records of diagnostic surveys, psychiatric interviews, blood and urine tests, and BP measurements, a team of researchers studied a representative sample of 4,181 adults aged 18-65 who had taken part in a nationwide health survey in Germany. After adjusting for sociodemographic factors and other common mental disorders, the investigators found that people with an anxiety or mood disorder or those who were abusing substances were 39% to 112% more likely than those without these problems to have thyroid disease, respiratory disease, GI disease, arthritis, migraine headaches, or allergies. The emotional problems included generalized anxiety, panic disorder, agoraphobia, social phobia, simple phobia, obsessive-compulsive disorder, depression, dysthymia, and bipolar disorder.

In addition, most people with both a psychic disorder and physical illness developed the emotional problem first and tended to have a poorer quality of life than those with emotional or physical ailments alone. The authors say that their findings “underscore the need for programs to recognize and treat anxiety disorders in the medically ill” (Arch Intern Med. 2006;166:2109-2116).

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