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Ageing International

, Volume 30, Issue 1, pp 88–104 | Cite as

Chronic physical conditions and aging: Is mental health a potential protective factor?

  • Corey L. M. Keyes
Professional Issues: Research Findings Invited Paper

Abstract

Research has shown that risk of chronic disease increases with age. Mental disorders and chronic disease are highly comorbid, with studies showing reciprocal causal relations. However, research focuses exclusively on combinations of, or a specific, mental illness. This study investigates the hypothesis that complete mental health is a protective factor against, while mental illness is a risk factor for, chronic (physical) conditions with age. Mental health is conceived of as a syndrome of subjective well-being consisting of symptoms of hedonia (positive feelings toward life) and eudaimonia (positive functioning in life). A categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, are described and applied to data from the MIDUS study of 3,032 adults, 25-74 years old. Data were also collected regarding 12-month prevalence of major depressive episode (MDE), and complete mental health is the absence of any of MDE and the presence of flourishing. Descriptive findings revealed a strong association of the complete mental health diagnostic categories with 23 of the 27 self-reported chronic conditions. In multivariate regression, quantity of chronic disease increased with age and was higher among moderately mentally healthy and adults with MDE, compared with the completely mentally healthy. Chronic conditions increased exponentially with age among adults with pure languishing and adults with languishing and a MDE. At all ages, completely mentally healthy adults reported the fewest chronic conditions, suggesting it may act as a protective factor in aging.

Keywords

Mental Health Mental Illness Chronic Condition Major Depression Major Depressive Episode 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Psychiatric Association. (1987).Diagnostic and statistical manual of mental disorders, Third edition (revised). Washington, D.C.: Author.Google Scholar
  2. American Psychiatric Association. (2000).Diagnostic and statistical manual of mental disorders, Fourth edition (text revision). Washington, D.C.: Author.Google Scholar
  3. Anderson, R.J., Freedland, K.E., Clouse, R.E., & Lustman, P.J. (2001). The prevalence of comorbid depression in adults with diabetes: A meta-analysis.Diabetes Care, 24, 1069–1078.CrossRefGoogle Scholar
  4. Bodurka-Bevers, D., Basen-Engquist, K., Carmack, C.L., Fitzgerald, M.A., Wolf, J.K., de Moor, C., & Gershenson, D. M. (2000). Depression, anxiety, and quality of life in patients’ epithelial ovarian cancer.Gynecologic Oncology, 78, 302–308.CrossRefGoogle Scholar
  5. Brazier, J.E., Harper, R., Jones, N.M.B., O’Cathain, A., Usherwood, T., & Westlake, J. (1992). Validating the SF-36 health survey questionnaire: New outcome measure for primary care.British Medical Journal, 305, 160–164.Google Scholar
  6. Carney, R.M., Freedland, K.E., Sheline, Y.I., & Weiss, E.S. (1997). Depression and coronary heart disease: A review for cardiologists.Clinical Cardiology, 20, 196–200.Google Scholar
  7. Danner, D.D., Snowdon, D.A., & Friesen, W.V. (2001). Positive emotions in early life and longevity: Findings from the nun study.Journal of Personality and Social Psychology, 80, 804–813.CrossRefGoogle Scholar
  8. Epels, E.S., Blackburn, E.H., Lin, J., Dhabhar, F.S., Adler, N.E., Morrow, J.D., & Cawthon, R.M. (2004). Accelerated telomere shortening in response to life stress.Proceedings of the National Academy of Science, 101, 17312–17315.CrossRefGoogle Scholar
  9. Frasure-Smith, N, & Lesperance, F. (in press). Depression and coronary heart disease: Complex synergism of mind, body, and environment.Current Directions in Psychological Science.Google Scholar
  10. Ford, D.E., Mead, L.A., Chang, P.P., Cooper-Patrick, L., Wang, N-Y., & Klag, M.J. (1998). Depression is a risk factor for coronary artery disease in men: The precursors study.Archives of Internal Medicine, 158, 1422–1426.CrossRefGoogle Scholar
  11. Glassman, A.H., & Shapiro, P.A. (1998). Depression and the course of coronary artery disease.American Journal of Psychiatry, 155, 4–11.Google Scholar
  12. Greenberg, P.E., Stiglin, L.E., Finkelstein, S.N., & Berndt, E.R. (1993). The economic burden of depression in 1990.Journal of Clinical Psychiatry, 54, 405–418.Google Scholar
  13. Grundy, S.M. (1999). Age as a risk factor: You are as old as your arteries.American Journal of Cardiology, 83, 1455–1457.CrossRefGoogle Scholar
  14. Jette, A.M. (1996). Disability trends and transitions. In R.H. Binstock & L.K. George (Eds.),Handbook of Aging and the Social Sciences (pp. 94–116). San Diego, CA: Academic Press.Google Scholar
  15. Jonas, B.S., & Mussolino, M.E. (2000). Symptoms of depression as a prospective risk factor for stroke.Psychosomatic Medicine, 62, 463–471.Google Scholar
  16. Keyes, C.L.M. (1998). Social well-being.Social Psychology Quarterly, 61, 121–140.CrossRefGoogle Scholar
  17. Keyes, C.L.M. (2002). The mental health continuum: From languishing to flourishing in life.Journal of Health and Social Behavior, 43, 207–222.CrossRefGoogle Scholar
  18. Keyes, C.L.M. (2003). Complete mental health: An agenda for the 21st century. In C.L.M. Keyes, & J. Haidt (Eds.),Flourishing: Positive Psychology and the Life Well-Lived (pp. 293–312). Washington, D.C.: American Psychological Association Press.CrossRefGoogle Scholar
  19. Keyes, C.L.M. (2004a). The nexus of cardiovascular disease and depression revisited: The complete mental health perspective and the moderating role of age and gender.Aging and Mental Health, 8, 266–274.CrossRefGoogle Scholar
  20. Keyes, C.L.M. (2004b). Risk and resilience in human development: An introduction.Research in Human Development, 1, 223–227.CrossRefGoogle Scholar
  21. Keyes, C.L.M. (2005). Mental illnessand/or mental health? Investigating axioms of the Complete State Model of Health.Journal of Consulting and Clinical Psychology, 73, 539–548.CrossRefGoogle Scholar
  22. Keyes, C.L.M., & Lopez, S.J. (2002). Toward a science of mental health: Positive directions in diagnosis and interventions. In C.R. Snyder, & S.J. Lopez (Eds.),Handbook of Positive Psychology (pp. 45–59). New York: Oxford University Press.Google Scholar
  23. Keyes, C.L.M., & Ryff, C.D. (2003). Somatization and mental health: A comparative study of the idiom of distress hypothesis.Social Science and Medicine, 57, 1833–1845.CrossRefGoogle Scholar
  24. Keyes, C.L.M. Shmotkin, D., & Ryff, C.D. (2002). Optimizing well-being: The empirical encounter of two traditions.Journal of Personality and Social Psychology, 82, 1007–1022.CrossRefGoogle Scholar
  25. Keyes, C.L.M., & Waterman, M.B. (2003). Dimensions of well-being and mental health in adulthood. In Bornstein, M., Davidson, L., Keyes, C.L.M., & Moore, K. (Eds.),Well-being: Positive development throughout the life course (pp. 477–497). Mahwah, NJ: Erlbaum.Google Scholar
  26. Kraemer, H.C., Kazdin, A.E., Offord, D.R., Kessler, R.C., Jensen, P.S., & Kupfer, D.J. (1997). Coming to terms with the terms of risk.Archives of General Psychiatry, 54, 337–343.Google Scholar
  27. Lakatta, E.G. (1999). Cardiovascular aging research: The next horizons.Journal of the American Geriatrics Society, 47, 613–625.Google Scholar
  28. Lesperance, F., Frasure-Smith, N., & Talajic. M. (1996). Major depression before and after myocardial infarction: Its nature and consequences.Psychosomatic Medicine, 58, 99–110.Google Scholar
  29. Mancuso, C.A., Peterson, M.G, & Charlson, M.W. (2000). Effects of depressive symptoms on health-related quality of life in asthma patients.Journal of General Internal Medicine, 15, 301–310.CrossRefGoogle Scholar
  30. Masten, A.S. (2001). Ordinary magic: Resilience processes in development.American Psychologist, 56, 227–238.CrossRefGoogle Scholar
  31. McElroy, S.L., Kotwal, R., Malhotra, S., Nelson, E.B., Keck, P.E., & Nemeroff, C.B. (2004). Are mood disorders and obesity related? A review for the mental health professional.Journal of Clinical Psychiatry, 65, 245–251.Google Scholar
  32. McEwen, B.S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load.Annals of the New York Academy of Science, 840, 33–44.CrossRefGoogle Scholar
  33. Murray, C.J.L., & Lopez, A. D. (Eds.) (1996).The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard School of Public Health.Google Scholar
  34. Murray, C.J.L., & Lopez, A.D. (1997). Global mortality, disability, and the contribution of risk factors: Global burden of disease study.Lancet, 349, 1436–1442.CrossRefGoogle Scholar
  35. Musil, C.M., Morris, D.L., Haug, M.R., Warner, C.B., & Whelan, A.T. (2001). Recurrent symptoms: Well-being and management.Social Science and Medicine, 52, 1729–1740.CrossRefGoogle Scholar
  36. Musselman, D.L., Evans, D.L., & Nemeroff, C.B. (1998). The relationship of depression to cardiovascular disease: Epidemiology, biology, and treatment.Archives of General Psychiatry, 55, 580–592.CrossRefGoogle Scholar
  37. Nusselder, W.J., van der Velden, K., von Sonsbeek, J.L.A., Lenoir, M.E., & van den Bos, G.A.M. (1996). The elimination of selected chronic diseases in a population: The compression and expansion of morbidity.American Journal of Public Health, 86, 187–194.CrossRefGoogle Scholar
  38. Olshansky, S.J., Rudberg, M.A., Carnes, B.A., Cassell, C.K., & Brody, J.A. (1991). Trading off longer life for worsening health.Journal of Aging and Health, 3, 194–216.CrossRefGoogle Scholar
  39. Ostir, G.V., Markides, K.S., Black, S.A., & Goodwin, J.S. (2000). Emotional well-being predicts subsequent functional independence and survival.Journal of the American Geriatrics Society, 48(5), 473–478.Google Scholar
  40. Penninx, B.W.J.H, Guralnik, J.M., Simonsick, E.M., Kasper, J.D., Ferrucci, L., & Fried, L.P. (1998). Emotional vitality among disabled older women: The Women’s Health and Aging Study.Journal of the American Geriatrics Society, 46, 807–815.Google Scholar
  41. Rugulies, R. (2002). Depression as a predictor for coronary heart disease: A review and meta-analysis.American Journal of Preventive Medicine, 23, 51–61.CrossRefGoogle Scholar
  42. Wells, K.B., Golding, J.M., & Burnam, M.A. (1989). Affective, substance use, and anxiety disorders in persons with arthritis, diabetes, heart disease, high blood pressure, or chronic lung conditions.General Hospital Psychiatry, 11, 320–327.CrossRefGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Corey L. M. Keyes
    • 1
  1. 1.Department of SociologyEmory UniversityAtlanta

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