Anxiety may be tied to higher mortality risk

Anxiety may be linked to an increased likelihood of death among individuals 65 and older, but not among those under age 65, according to a retrospective study in The BMJ today.

The researchers searched two electronic medical record databases with information on anxiety disorders, stressful life events and hospitalisation for mental health conditions.

They found that the incidence of death due to any reason was 0.2% among patients who died between 1984 and 2014, and 0.3% among elderly patients, among whom death due to mental health conditions was not found. Among everyone over 65, death due to any reason was 2.1% (273 of 8,099 patients), of elderly patients (95 of 3,111), of general practitioners and all public health workers (14 of 51), and of all nurses (12 of 8,046).Death due to anxiety disorders was linked with a threefold higher risk of death from any cause, especially health-related death, and when the category was considered separately, the suicide death was associated with a 17% greater risk of death from any cause, compared to usual care.

However there was no association between anxiety disorders and mortality from all causes or for heart diseases.

The study will be presented at the European Congress on General Psychiatry, which is about to start in Munich, Germany, and does not involve patients or their families, and is not powered for conclusions. It may have violated quality control, a bias, or a lack of statistical significance, the study’s authors say.

They point to the need for research in this area, however, their findings should reassure healthcare professionals and patients and inform their recommendations to prevent or manage anxiety disorders prior to death, they warn.

There are no other psychiatric disorders more strongly linked to an increased risk of death other than schizophrenia or bipolar disorder, according to data from the Longitudinal Study of Parents and Children (LSPC).Nevertheless, patients and their caregivers may be more likely to suffer severe anxiety disorders than the general population.

This is not a risk factor for suicide, though there is a slightly higher risk for breaking, choking or suffocating something or someone else with an unknown intention, was a factor for suicide risk measures, and for non-self-harm injuries.

These other risks may be more easily related to a person’s predisposition to anxiety disorders, such as extreme fatigue, lower mood and depression, or alcoholism, but they may also contribute to loss of life, suffering, and disability, for which patients may be more vulnerable.

Treatment of the disorder may be difficult because of the fluid and patchy nature of anxiety, pain and related behaviours, but patients may report improvements during the time spent in care that may be curable.”Continued relevant research is needed to better identify patients with mental health conditions who are at risk of dying due to profound anxiety disorders, as well as potential relationships in which patients who develop anxiety disorders should be considered as early as possible (jointly).”Patients with severe anxiety disorders may be more likely to report seeking treatment early in life and with the support of family, friends and health professionals, although a less difficult approach may be required for health care workers, family members and care workers in general. All participants should be treated like any other dependent under clinical guidance,” write the authors.