Anxiety Disorders May be Linked to Physical Illness

By Corinna Underwood

Anxiety disorders appear to be independently associated with several physical conditions, including thyroid disease, respiratory disease, arthritis and migraine headaches. Although depression has long been linked to physical illness, evidence supporting an association between anxiety disorders and physical health problems is more recent.

Anxiety disorders include panic disorder, agoraphobia, social phobia and obsessive-compulsive disorder. Studies have found that those with phobic anxiety may be more likely to experience sudden cardiac death, and rates of anxiety disorders are higher than expected in patients with thyroid disease, cancer, hypertension and several other conditions.

Dr. Jitender Sareen, from the University of Manitoba, Winnipeg, Canada, and colleagues explored the association between anxiety disorders and physical conditions in 4,181 adults who were part of the German Health Survey (GHS), conducted between 1997 and 1999. The survey assessed whether participants had any physical illnesses through a questionnaire asking about 44 particular conditions, a medical interview conducted by a primary care physician, blood pressure measurements and blood and urine samples. Psychiatric interviews were conducted by a psychologist or physician, who used criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to detect anxiety disorders. A quality of life survey—which measured factors such as physical functioning, pain and general health—was also administered, and to determine disability levels participants reported how many days of the past 30 they were unable to perform their usual daily activities.

Though the mechanisms of association between anxiety disorders and physical conditions remain unknown, several possibilities should be considered, according to the researchers. For example, the presence of an illness may cause worry and anxiety that eventually becomes serious enough to qualify as an anxiety disorder, the presence of an anxiety disorders could trigger biological processes that contribute to illness or a third condition, such as a substance abuse disorder, could be linked to both.