Mood and anxiety profiles differentially associate with physical conditions in US adolescents

Emma K Stapp; Diana Paksarian; Jian-Ping He; Jennifer Glaus; Kevin P Conway; Kathleen R Merikangas

doi:10.1016/j.jad.2021.11.056

Mood and anxiety profiles differentially associate with physical conditions in US adolescents

J Affect Disord. 2022 Feb 15:299:22-30. doi: 10.1016/j.jad.2021.11.056. Epub 2021 Nov 24.

Authors

Emma K Stapp¹, Diana Paksarian¹, Jian-Ping He¹, Jennifer Glaus², Kevin P Conway¹, Kathleen R Merikangas³

Affiliations

¹ Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
² Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
³ Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA. Electronic address: kathleen.merikangas@nih.gov.

Abstract

Background: Mood and anxiety are widely associated with physical conditions, but research and treatment are complicated by their overlap, clinical heterogeneity, and manifestation on a spectrum rather than as discrete disorders. In contrast to previous work relying on threshold-level disorders, we examined the association between empirically-derived profiles of mood and anxiety syndromes with physical conditions in a nationally-representative sample of US adolescents.

Methods: Participants were 2,911 adolescents (aged 13-18) from the National Comorbidity Survey-Adolescent Supplement who provided information on physical conditions and reported at least one lifetime mood-anxiety 'syndrome' based on direct interviews with the Composite International Diagnostic Interview Version 3.0. Mood-anxiety syndromes reflected 3-level ratings from subthreshold to severe distress/impairment, and subtyped mood episodes. Stepwise latent profile analysis identified mood-anxiety profiles and tested associations with physical conditions.

Results: Three mood-anxiety profiles were identified: "Mood-GAD" (25.6%)-non-atypical depression, mania, generalized anxiety; "Atypical-Panic" (11.3%)-atypical depression, panic; and "Reference" (63.1%)-lower mood and anxiety except specific phobia. Headaches were more prevalent in Mood-GAD and Atypical-Panic than Reference (47.9%, 50.1%, and 37.7%, respectively; p=0.011). Heart problems were more common in Mood-GAD than Atypical-Panic (7.4% v 2.2%, p=0.004) and Reference, with back/neck pain more prevalent in Mood-GAD than Reference (22.5% v 15.3%, p=0.016).

Limitations: Broad categories of physical conditions without information on specific diagnoses; replication regarding specificity is recommended.

Conclusions: Heart problems and pain-related conditions were differentially associated with specific mood-anxiety profiles. Subtyping depression and anxiety-inclusive of subthreshold syndromes-and their patterns of clustering may facilitate etiologic and intervention work in multimorbidity.

Keywords: Anxiety disorders; Chronic pain; Headache; Heart diseases; Mood disorders.

Publication types

Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

MeSH terms

Adolescent
Anxiety / epidemiology
Anxiety Disorders* / diagnosis
Anxiety Disorders* / epidemiology
Comorbidity
Humans
Panic
Phobic Disorders*
Prevalence

Abstract

Publication types

MeSH terms

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