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Depression Without Anxiety Can Be as Deadly as Smoking


A Norwegian study using a unique link between a survey of over 60,000 people and a comprehensive mortality database has found that the risk of dying from depression is equivalent to the risk from smoking. It is interesting to note that if an individual displays anxiety along with depression, then the risk of dying is less than that of depression alone.

Dr. Robert Stewart, who led the research team at the study states, “Unlike smoking, we don’t know how causal the association with depression is but it does suggest that more attention should be paid to this link because the association persisted after adjusting for many other factors.”

The study showed something that researchers might not have expected, and that was if patients had a combination of depression and anxiety that it actually lowered mortality compared with depression alone. Dr. Stewart explains, “One of the main messages from this research is that a little anxiety may be good for you.”

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Stewart said,”It appears that we’re talking about two risk groups here. People with very high levels of anxiety symptoms may be naturally more vulnerable due to stress, for example through the effects stress has on cardiovascular outcomes. On the other hand, people who score very low on anxiety measures, i.e. those who deny any symptoms at all, may be people who also tend not to seek help for physical conditions, or they may be people who tend to take risks. This would explain the higher mortality.”

Dr. Stewart further states, “It would certainly not surprise me at all to find that doctors are less likely to investigate physical symptoms in people with depression because they think that depression is the explanation, but may be more likely to investigate if someone is anxious because they think it will reassure them. These are conjectures but they would fit with the data.”

He and his researchers explain that when looking at the results, it is important to consider a variety of adverse physical health outcomes and poor health associated with mental disorders such as depression and psychotic disorders.

Dr. Stewart believes that there should be a focus of future developments in the treatment of depression and anxiety: “The physical health of people with current or previous mental disorder needs a lot more attention than it gets at the moment. “

Stewart says, “This applies to primary care, secondary mental health care and general hospital care in the sense that there should be more active screening for physical disorders and risk factors, such as blood pressure, cholesterol, adverse diet, smoking, lack of exercise, in people with mental disorders. This should be done in addition to more active treatment of disorders when present, and more effective general health promotion.” What Stewarts study did confirm that depression alone can be as deadly as smoking.