Associations of self-reported anxiety symptoms with health-related quality of life and health behaviors
Anxiety disorders affect approximately 19 million American adults annually and have been associated with impaired health-related quality of life (HRQOL), an increased rate of adverse health behaviors, and poor outcomes related to chronic illness in studies conducted in clinical populations. Our study was designed to examine the association of self-reported anxiety symptoms with HRQOL and health behaviors among a representative sample of US community-dwellers.
Data were obtained from the Behavioral Risk Factor Surveillance System,an ongoing, state-based, random-digit telephone survey of the noninstitutionalized US population aged ≥ 18 years. In 2002, HRQOL measures were administered in 18 states and the District of Columbia.
An estimated 15% of persons reported frequent (≥ 14 days in the past 30 days) anxiety symptoms. After adjusting for frequent depressive symptoms and sociodemographic characteristics, those with frequent anxiety symptoms were significantly more likely than those without to report fair or poor general health (vs. excellent, very good, or good general health), frequent physical distress, frequent activity limitations, frequent sleep insufficiency, infrequent vitality, frequent mental distress, and frequent pain. In addition, they were more likely to smoke, to be obese, to be physically inactive, and to drink heavily.
Given their association with impaired HRQOL and adverse health behaviors, our results suggest that assessment of anxiety symptoms should be a facet of routine standard medical examinations.
Key wordsanxiety quality of life health behaviors surveillance mental health
Unable to display preview. Download preview PDF.
- 1.US Department of Health and Human Services (1999) Mental health: a report of the Surgeon General—executive summary. US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institutes of Mental Health. Rockville, MD. Available at: http://www.surgeongeneral.gov/library/mentalhealth/home.html (accessed: May 25, 2005)Google Scholar
- 2.Lang PJ (1977) Physiological assessment of anxiety and fear. In: Cone JD, Hawkins RP (eds) Behavioral Assessment: New Directions in Clinical Psychology. Brunner/Mazel, New York, pp 178–195Google Scholar
- 3.National Institute of Mental Health (2002) Anxiety disorders (NIH Publication No. 02–3879). Available at: http://www.nimh.nih.gov/publicat/anxiety.cfm (accessed: May 25, 2005)Google Scholar
- 4.National Mental Health Association.Anxiety disorders.Available at: http://www.nmha.org/pbedu/anxiety/anxdis.cfm (accessed: May 25, 2005)Google Scholar
- 6.Lépine JP (2002) The epidemiology of anxiety disorders: prevalence and societal costs. J Clin Psychiatry 63(Suppl 14):4–8Google Scholar
- 7.Lecrubier Y (2001) The burden of depression and anxiety in general medicine. J Clin Psychiatry 62(Suppl 8):4–9Google Scholar
- 10.National Academy of Sciences (2001) Biobehavioral Factors in Health and Disease. In: Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. National Academy Press, Washington DC, pp 39–86Google Scholar
- 19.Holtzman D (2004) The Behavioral Risk Factor Surveillance System. In: Blumenthal DS, DiClemente RJ (eds) Communitybased health research: issues and methods. New York: Springer Publishing Company, Inc.Google Scholar
- 20.Mokdad AH, Stroup DF, et al. (2003) Public health surveillance for behavioral risk factors in a changing environment. Recommendations from the Behavioral Risk Factor Surveillance Team. MMWR Morb Mortal Wkly Rep 52(RR-9):1–12Google Scholar
- 21.Centers for Disease Control and Prevention. National Center for Disease Prevention and Health Promotion. Behavioral Risk Factor Surveillance System home page. Available at: http://www.cdc.gov/brfss (accessed:May 25, 2005)Google Scholar
- 22.Centers for Disease Control and Prevention.National Center for Disease Prevention and Health Promotion. Behavioral Risk Factor Surveillance System’s User Guide. Available: http://www.cdc.gov/BRFSS/pdf/userguide.pdf. (accessed: May 25, 2005)Google Scholar
- 24.Newschaffer CJ, Validation of Behavioral Risk Factor Surveillance System HRQOL measures in a statewide sample. Synopsis available at: http://www.cdc.gov/hrqol/measurement_properties/newschaffer.htm. (accessed: May 25, 2005). Copies of these studies are available by contacting the CDC HRQOL Program at 770/488–6087Google Scholar
- 25.Andreson EM, Fouts BS, et al. (1999) Performance of health-related quality of life instruments in a spinal cord injured population. Arch Phys Med Rehab 80:877–884Google Scholar
- 27.The dietary guidelines for Americans, 2000, 5th edition. US Department of Agriculture and the US Department of Health and Human Services. Available at: http://www.usda.gov/cnpp/dietary_guidelines.html (accessed: May 25, 2005)Google Scholar
- 33.Blashfield RK (1990) Comorbidity and classification. In: Maser JD, Cloninger CR (eds) Comorbidity of mood and anxiety disorders. Washington DC: American Psychiatric Press Inc, pp 61–82Google Scholar
- 34.Robinson DS, Kurtz NM (1990) Relationship between anxiety and depression affective development of antidepressant and antianxiety drugs. In: Maser JD, Cloninger CR (eds) Comorbidity of mood and anxiety disorders. Washington DC: American Psychiatric Press Inc, pp 639–726Google Scholar
- 47.Bandura A (1997) Health functioning. In: Self-efficacy—The Exercise of Control. WH, Freeman and Company, New York, pp 279–280Google Scholar