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

Ivana Bojanić; Erik R Sund; Hege Sletvold; Ottar Bjerkeset

doi:10.1186/s40359-021-00636-0

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

BMC Psychol. 2021 Aug 31;9(1):130. doi: 10.1186/s40359-021-00636-0.

Authors

Ivana Bojanić¹, Erik R Sund^{2

3

4}, Hege Sletvold², Ottar Bjerkeset^{2

5}

Affiliations

¹ Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway. ivana.bojanic@nord.no.
² Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway.
³ Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, NTNU, Levanger, Norway.
⁴ Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁵ Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, 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.

Keywords: Anxiety symptoms; Cardiovascular diseases; Depression symptoms; Diabetes mellitus; Multi-level models; Prevalence.

MeSH terms

Adult
Anxiety / epidemiology
Cardiovascular Diseases* / epidemiology
Depression / epidemiology
Diabetes Mellitus* / epidemiology
Female
Humans
Male
Norway / epidemiology
Prevalence