Online Program

Interrelationships between depression, anxiety, and chronic disease among Maine adults: A call to action for Maine chronic disease programs

Monday, November 4, 2013

Sara Huston, University of Southern Maine / Maine Center for Disease Control & Prevention, Augusta, ME
Prashant Mittal, MSc, MS, Muskie School of Public Service, Univiersity of Southern Maine, Portland, ME
Elsie Freeman, MD MPH, Cutler Institute for Health and Social Policy, USM Muskie School of Public Service, Trevett, ME
Anne Conners, Maine Center for Disease Control and Prevention, Augusta, ME
Kip Neale, Maine Center for Disease Control and Prevention, Augusta, ME
Background: Although links between depression, anxiety and chronic disease are well-documented, state public health programs have not commonly integrated these issues into chronic disease-related interventions. We analyzed Maine Behavioral Risk Factor Surveillance System (BRFSS) data to increase Maine chronic disease program staff's awareness of the importance of depression/anxiety. Methods: We examined interrelationships between chronic conditions (hypertension, high cholesterol, prediabetes, diabetes, asthma, cancer, cardiovascular disease) and risk factors (obesity, physical activity, fruit/vegetable intake, smoking, heavy drinking) and lifetime depression/anxiety (current moderate/severe symptoms as measured by PHQ-8 or lifetime diagnosed depression or anxiety) among Maine adults using 2009-2010 BRFSS data. We used SAS 9.2 procedures appropriate for the design; all data were weighted. Results: One in ten Maine adults had current depression; three in ten had lifetime depression/anxiety. With few exceptions (drinking, fruit/vegetable intake, cardiovascular disease, cancer), the prevalence of lifetime depression/anxiety was significantly higher among Maine adults with chronic conditions and risk factors compared to those without (insufficient physical activity: 34.6% vs. 27.6%, smoking: 46.7% vs. 25.2%, obesity: 40.2% vs. 24.6%, hypertension: 35.5% vs. 28.4%, high cholesterol: 34.1% vs. 27.1%, prediabetes: 48.1% vs. 27.0%, diabetes: 38.2% vs. 28.4%, asthma: 46.5% vs. 27.3%). Discussion: Given the substantial prevalence of depression/anxiety among Maine adults with chronic conditions and risk factors and the impact depression/anxiety can have on making lifestyle changes and controlling chronic conditions, Maine public health programs must incorporate mental health issues into chronic disease-related interventions to be successful. We are using multiple dissemination approaches to reach Maine public health professionals.

Learning Areas:

Chronic disease management and prevention
Other professions or practice related to public health
Social and behavioral sciences

Learning Objectives:
Describe whether adults with chronic conditions and risk factors are more or less likely to have depression/anxiety. List at least two ways in which depression/anxiety can impact chronic disease prevention and control. Formulate ideas for analyses to look at depression and chronic disease in other states using similar data sources.

Keyword(s): Depression, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a doctoral degree in Epidemiology and more than 15 years of experience in applied public health epidemiology working at the state, national, and international levels. I have specific expertise in the analysis, interpretation, presentation, and dissemination of state, national, and local level chronic disease-related data for public health action.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.