Prevalence trends of depression and anxiety symptoms in adults with cardiovascular diseases and diabetes 1995–2019: The HUNT studies, Norway

Abstract

Background Symptoms of depression and anxiety are common in adults with cardiovascular diseases (CVDs) and diabetes mellitus (DM). The literature on depression and anxiety in CVDs and DM populations is extensive; however, studies examining these relationships over time, directly compared to adults without these conditions, are still lacking. This study aimed to investigate trends in depression and anxiety symptom prevalence over more than 20 years in adults with CVDs and DM compared to the general population. Methods We used data from the population-based Trøndelag Health Study (HUNT), Norway, including adults (≥ 20 years) from three waves; the HUNT2 (1995–97; n = 65,228), HUNT3 (2006–08; n = 50,800) and HUNT4 (2017–19; n = 56,042). Depressive and anxiety symptom prevalence was measured independently by the Hospital Anxiety and Depressions scale (HADS) in sex-stratified samples. We analyzed associations of these common psychological symptoms with CVDs and DM over time using multi-level random-effects models, accounting for repeated measurements and individual variation. Results Overall, the CVDs groups reported higher levels of depression than those free of CVDs in all waves of the study. Further, depressive and anxiety symptom prevalence in adults with and without CVDs and DM declined from HUNT2 to HUNT4, whereas women reported more anxiety than men. Positive associations of depression and anxiety symptoms with CVDs and DM in HUNT2 declined over time. However, associations of CVDs with depression symptoms remained over time in men. Moreover, in women, DM was associated with increased depression symptom risk in HUNT2 and HUNT4. Conclusions Depression and anxiety symptoms are frequent in adults with CVDs. Further, our time trend analysis indicates that anxiety and depression are differentially related to CVDs and DM and sex. This study highlights the importance of awareness and management of psychological symptoms in CVDs and DM populations.

Prevalence and risk factors for depressive and anxiety symptoms in middle-aged Chinese women: a community-based cross-sectional study

“…It has been estimated that the prevalence of depressive and anxiety symptoms was 26.0% and 12.6% among Chinese women aged 40 to 60 years, respectively [5]. Previous evidence has indicated that symptoms of depression and anxiety are associated with increased risk of cardiovascular diseases, osteoporosis and osteoporotic fractures that substantially affected morbidity and mortality for middle-aged women [6][7][8][9][10]. In addition, both depressive and anxiety symptoms have a deleterious influence on women's quality of life, sleep quality and life satisfaction during perimenopause [11][12][13].…”

Sex-Related Disparities in the Prevalence of Depression among Patients Hospitalized with Type 2 Diabetes Mellitus in Spain, 2011–2020

“…Screening for depression in clinical practice, particularly among people with diabetes, may be a useful first step in identifying patients at high risk of this disease. The change in the time trend of prevalence has been reported in various studies [ 21 , 22 , 23 ]. In a population-based study in Norway, Bojanic et al [ 21 ] found a general decrease in depressive symptoms in men with diabetes and relatively stable symptoms in women with this condition between 1995-97 and 2017-19, concluding that this change could be explained in part by awareness of these psychological conditions and improvements in treatment.…”

“…The change in the time trend of prevalence has been reported in various studies [ 21 , 22 , 23 ]. In a population-based study in Norway, Bojanic et al [ 21 ] found a general decrease in depressive symptoms in men with diabetes and relatively stable symptoms in women with this condition between 1995-97 and 2017-19, concluding that this change could be explained in part by awareness of these psychological conditions and improvements in treatment. Similarly, a decrease in prevalence was observed in a population-based study of Mexican adults with diabetes (age ≥ 50 years) between 2001 and 2015 [ 33 ].…”

“…Studies conducted in the last decades of the past century and first years of the current century showed that the prevalence of depression among people with diabetes was increasing in our country and elsewhere [ 17 , 18 , 19 , 20 ]. However, more recent investigations suggest that a change in the time trend may be taking place [ 21 , 22 , 23 ]. The lack of recent reports in our country makes necessary to confirm if this new tendency is also happening.…”

Associations of Cardiovascular Agents and Metformin with Depression Symptoms: A Cross-Sectional Analysis from the HUNT Study, Norway

“…Post hoc analysis of sex effects is also vulnerable to a type 1 error. Our previous study that investigated trends in depression and anxiety symptom prevalence over more than 20 years in adults with CVDs and DM compared to the general population showed that CVDs were consistently associated with increased depression symptom risk in men but not women [ 62 ]. In this study, the prevalence of CVDs and depression symptoms, together with statin or ASA use, was higher among men than women.…”