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Generalized Anxiety and Major Depressive Disorders, Their Comorbidity and Hypertension in Middle-Aged Men

From the School of Sport and Exercise Sciences (D.C., A.C.P.), University of Birmingham, Birmingham, UK; MRC Epidemiology Resource Centre (C.R.G.), University of Southampton, Southampton, UK; Centre for Cognitive Ageing and Cognitive Epidemiology (G.D.B.), Department of Psychology, University of Edinburgh, Edinburgh, UK; MRC Social and Public Health Sciences Unit (G.D.B.), University of Glasgow, Glasgow, UK; and The George Institute for International Health (G.D.B.), University of Sydney, Sydney, Australia.

Address correspondence and reprint requests to Douglas Carroll, School of Sport and Exercise Sciences, University of Birmingham, Birmingham B15 2TT, UK. E-mail: carrolld{at}bham.ac.uk

Objective: To examine the cross-sectional associations between generalized anxiety disorder (GAD) and major depressive disorder (MDD), their comorbidity, and hypertension.

Methods: Participants (n = 4180) were drawn from a cohort of men who were members of the U.S. army during the Vietnam war era. Occupational, sociodemographic, and health data were collected from military service files, telephone interviews, and medical examinations. Hypertension status was defined by the presence of one of the following: self-reports at interview of either a physician-diagnosis or taking antihypertensive medication; or an average systolic blood pressure 140 mm Hg or an average diastolic blood pressure 90 mm Hg at the medical examination. One-year prevalence of GAD and MDD was determined, using Diagnostic and Statistical Manual of Mental Disorders, Third Edition criteria.

Results: In separate regression models adjusting for age and then additionally for place of service, ethnicity, marital status, alcohol consumption, smoking, body mass index, household income, and education grade, both GAD and MDD were related positively to hypertension. In age-adjusted and fully adjusted models comparing comorbid GAD/MDD, GAD alone, MDD alone, and neither condition, comorbidity showed the strongest relationship with hypertension.

Conclusion: Depression has been the main focus for research on mental health and physical health outcomes. The present results suggest that future research should pay equal attention to GAD and, in particular, the comorbidity of GAD and MDD.

Key Words: generalized anxiety disorder • major depressive disorder • comorbidity • hypertension • veterans

Abbreviations: BMI = body mass index; GAD = generalized anxiety disorder; MDD = major depressive disorder.

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