(i) Were observational studies analyzing the longitudinal association between anxiety or depression (disorders as well as symptom severity) and QoL,
(ii) Analyzed samples without a specific disease or disorder other than anxiety and depression,
(iii) Applied appropriate, validated measures for the main variables (e.g., for anxiety/depression: psychiatric diagnosis according to criteria of the International Classification of Diseases (ICD), the Diagnostic and Statistical Manual of Mental Disorders (DSM), or using a valid self-report screening tool), and
(iv) Were published in English or German in a peer-reviewed journal.
Abbreviations: QoL = quality of life; ICD = International Classification of Diseases; DSM = Diagnostic and Statistical Manual of Mental Disorders; BL = study baseline; KIDSCREEN = Health Related Quality of Life Questionnaire for Children and Young People and their Parents; KINDL = German generic quality of life instrument for children
We extracted information regarding the study design, operationalization of the variables, sample characteristics, statistical methods and results regarding the research question of interest. If several analyses were presented for the same research question, we extracted the final covariate-adjusted model for narrative synthesis. Data were extracted by one reviewer (J.K.H.) and cross-checked by a second reviewer (E.Q.). If needed, extracted data were standardized (e.g., by calculating the weighted average means when combining groups) to present comparable information. If clarification was needed, the corresponding authors were contacted.
For the narrative synthesis, all studies were first grouped by research question, e.g., whether disorders or the degree of symptoms were analyzed, which comparison groups were used, which QoL domains were considered, and at which waves the variables of interest were considered in the analyses. Because research questions and analyses were heterogeneous, a concise narrative synthesis of the main results of all studies was not feasible. Therefore, we provide an overview of all identified studies in the tables and a detailed narrative synthesis of those studies, analyzing trajectories of disorders or changes in symptoms in association with changes in QoL over time.
Additionally, we examined whether data were appropriate for meta-analysis. The specific research questions, the operationalization of main variables and statistical methods were heterogeneous across studies and not all the statistical estimates needed could be obtained from covariate-adjusted analyses. Therefore, to enhance the comparability of the underlying data and the interpretation of the pooled estimates, we used descriptive information. Because most papers applied variations of the Short Form Health Survey and analyzed mental and physical component scores (MCS, PCS), we considered these studies as eligible for meta-analysis. The necessary information could be obtained for 8 publications. Random-effects meta-analysis was used for pooling. Heterogeneity was assessed by means of I 2 , with higher values representing a larger degree of heterogeneity in terms of variability in effect size estimates between studies [ 41 ]. Pooled estimates are reported as Hedge’s g standardized mean difference (SMD), representing the difference in mean outcomes between groups relative to outcome measure variability [ 42 ]. According to Cohen (as cited in [ 43 ]), SMDs can be grouped into small ≤0.20, medium = 0.50 and large effects ≥0.80. Stata 16 was used for meta-analyses.
Two reviewers (J.K.H., E.Q.) independently assessed the quality and risk of bias of the included studies using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, which was developed by the National Heart, Lung, and Blood Institute [ 44 ].
The literature search yielded 4027 unique references. After title/abstract screening, 215 studies were included for full-text screening. Finally, 47 publications were included in the final synthesis. During full-text screening, most studies were excluded because they exclusively analyzed data on a cross-sectional level (56.5%). For further details, see the PRISMA flow chart ( Figure 1 ).
Descriptive characteristics and quality/risk of bias assessment of the included studies are provided in Table S1 (Supplementary Material) . In short, sample size ranged from 28 to 43,093. Most studies focused on adults; only four analyzed children/adolescents. Regarding the settings, 17 of the analyzed samples were exclusively recruited in a health care setting, 12 of the studies analyzed general population samples, 14 recruited in another or in several settings, and all studies on children/adolescents recruited in schools ( n = 4). Twenty studies (42.6%) applied data from the same seven underlying datasets. Most studies reported on depression ( n = 36), less reported on anxiety ( n = 20) and some reported on the comorbidity between depression and anxiety ( n = 7). To assess mental disorders, half (48.9%) used structured interviews. Regarding QoL, most studies applied variations of the Short Form Health Survey (SF, n = 27) or the WHOQOL ( n = 12). A total of 38.3% of the studies were rated as “good”, 55.3% as “fair” and 6.4% as “poor” in the quality assessment.
Detailed results on all studies investigating the association between anxiety/depression as independent variables and QoL outcomes are reported in Table 2 . As described in the methods section, the following paragraphs give an overview of those studies focusing on disorder trajectories/changes in symptoms over time and changes in QoL outcomes over time, because they allow for more differentiated interpretations.
Studies on depression/anxiety as independent variables and QoL outcomes.
First Author (Year) | Disorder or Symptoms Analyzed; QoL Domains Analyzed | Research Question Regarding QoL | Methods | Results |
---|---|---|---|---|
Årdal (2013) [ ] | Controls and patients in the acute phase of recurrent MD and FU (DSM-IV, HDRS); SF-36 (physical functioning, role physical, vitality, bodily pain, mental health, role emotional, social functioning, general health, as well as summary scores PCS, MCS and total score) | (a) Whether QoL scores differ between MD patients and healthy comparisons across domains over time. (b) Whether QoL in patients with recurrent MDD differed between acute phase and recovery. | (a) ANOVA (b) Paired-sample -tests | (a) There was a significant interaction effect between time, QoL domain and group, indicating that QoL scores differed between MD patients and controls over time. Compared to the healthy control group, the MDD group had reduced QoL in all domains at BL and reduced QoL in several domains at FU (significant for general health, social, emotional role, mental health, PCS, MCS and total score). (b) In the MD group, QoL scores significantly improved during recovery from recurrent MDD in most domains (significant for physical functioning, physical role, vitality, social functioning, role emotional, mental health, PCS, MCS and total score). |
Buist-Bouwman (2004) [ ] | Onset, acute phase and subsequent remission from MDE (CIDI); comorbid anxiety disorder (CIDI); SF-36 (physical functioning, physical role, vitality, pain, psychological health, psychological role, social functioning and general health) | (a) Whether incident MDE and recovery from MDE are associated with changes in QoL and whether pre- and post-morbid QoL scores in the MD group differ from the comparison group without MD. (b) In the subgroup with worse QoL after MDE: whether the severity of depression and number of depressive episodes were associated with worse QoL. (c) Whether comorbid anxiety during MDE is associated with reduced QoL (i.e., lower QoL after MDE compared to before MDE). | (a)–(c) Multivariate logistic regression | (a) Incident MDE was associated with a drop in QoL (significant for vitality, psychological, psychological role and social functioning). Subsequent recovery from MDE was associated with an improvement in QoL (significant for physical role, vitality, psychological health, psychological role, social functioning and general health). Comparing pre- and post-morbid levels, QoL did not differ or was higher after MDE in some domains (significantly higher for psychological health and psychological role). Moreover, before MD onset, QoL was significantly lower compared to healthy controls in all domains. After remission from MDE, QoL scores in nearly all domains (not significant for psychological role) were significantly lower compared to healthy controls. (b) About 40% of the MDE group had worse QoL after recovery from MDE compared to pre-morbid levels. The severity of depression was associated with worse QoL only for the psychological health domain, but no other domains. The number of depressive episodes was not significantly associated with worsening QoL in any domain. (c) In the MDE cohort, comorbid anxiety was associated with a significant reduction in QoL (significant for physical role and psychological health). |
Cabello (2014) [ ] | Chronic MD (AUDADIS interview; summary score of the number of symptoms to identify severity); SF-12, “disability” (i.e., domain-specific reduced QoL, defined as score ≤ 25th percentile in the subscale; physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role and mental health) | (a) Whether chronic MD is associated with the incidence/persistence of “disability” (i.e., reduced QoL) in a general population sample. (b) Whether the severity of depressive symptoms is associated with the incidence/persistence of “disability” (i.e., reduced QoL) in the MD subgroup of the sample. | Both (a) and (b) Generalized Estimating Equations and logistic regressions | (a) In the general population, chronic MD was a significant risk factor for the persistence of disability (i.e., reduced QoL) in all domains and of the incidence of disability (i.e., reduced QoL) in all domains except for the physical role. (b) In the chronic MD subgroup, the severity of depressive symptoms was associated with the persistence of disability (i.e., reduced QoL) (significant for general health, social functioning, emotional role and mental health) and not significantly associated with the incidence of reduced QoL in any domain. |
Cerne (2013) [ ] | Number of depressive episodes over time according to CIDI; number of episodes of panic and other anxiety syndromes over time (PHQ); SF-12 (PCS, MCS) | Whether the pooled number of (a) depressive episodes over time, (b) panic and anxiety episodes over time are are associated with the pooled QoL over time. | (a) and (b) Multivariate linear regression | (a) A higher number of depressive episodes over time was associated with lower pooled PCS and MCS. (b) a higher number of pooled panic episodes over time was associated with a lower mean MCS but not PCS. A higher number of pooled other anxiety syndrome episodes over time was not associated with the mean MCS or PCS. |
Chin (2015) [ ] | Depression according to PHQ-9 (>9), clinician’s diagnosis; SF-12v2 (PCS, MCS) | (a) Whether depressive symptoms and a clinician’s detection of depression at BL are associated with QoL at FU. (b) Whether a clinician’s detection of depression at BL is associated with a change in QoL. | (a) Multivariable non-linear mixed-effects regression (b) Independent -tests | (a) Depressive symptoms and a clinician’s detection of depression at BL were not predictive of QoL at FU. (b) A clinician’s detection of depression at BL was related to change (improvement) in MCS, but not PCS over time in a primary care sample screened as positive for depression. |
Chung (2012) [ ] | Depression diagnosis and symptoms (DSM-IV, HRSD depression scale, HADS depression scale); anxiety symptoms (HRSD anxiety scale, HADS anxiety scale; SF-36 (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health, PCS and MCS) | (a) Whether BL depressive symptoms are associated with QoL at FU. (b) Whether BL depressive symptoms or changes in depressive symptoms are associated with changes in QoL over time. (c) Whether BL anxiety symptoms are associated with QoL at FU. (d) Whether BL anxiety symptoms or changes in anxiety symptoms are associated with changes in QoL over time. | (a)–(d) Hierarchical regression | (a) BL depressive symptoms were not associated with any QoL domain at FU. (b) BL depressive symptoms were not associated with changes in any QoL domain over time. Changes in depressive symptoms were significantly associated with changes in some QoL domains over time (significant for: general health, vitality, mental health and MCS). (c) BL anxiety symptoms were not associated with any QoL domain at FU. (d) BL anxiety symptoms were not associated with changes in any QoL domain over time. Changes in anxiety symptoms were significantly associated with changes in some QoL domains over time (significant for: bodily pain, general health and mental health). |
Diehr (2006) [ ] | Depression according to CIDI, CES-D (>16); QLDS, WHOQOL-Bref (environmental, physical, psychological and social), SF-12 (PCS, MCS) | (a) Whether the quartile of change in depressive symptoms is associated with changes in QoL. (b) Whether the remission of depression at FU is associated with changes in QoL. | Regression | (a) No/little change in CES-D associated with changes in QoL over time (significant for SF-12 MCS). Every other quartile of change in depressive symptoms was significantly associated with changes in QoL in most scales/domains (significant for: QLDS, all domains of WHOQOL-Bref and SF-12 MCS), meaning a higher reduction in depressive symptoms was associated with a higher increase in QoL, and more severe depressive symptoms were associated with a reduction in QoL. (b) Remission of depression at FU was associated with improvement in all QoL measures and domains (SF-12, QLDS and WHOQOL-Bref). There was no significant change in QoL in those with persistent clinical depression at FU. |
Hajek (2015) [ ] | Depressive symptoms (GDS); EQ-VAS | Whether an initial change in depressive symptoms is associated with a subsequent change in QoL in the whole sample and by sex. | Vector autoregressive models | No significant association between an initial change in depression score and a subsequent change in QoL was found for the whole sample or stratified by sex. |
Hasche (2010) [ ] | Depression status at BL (according to DIS diagnosis and CES-D ≥ 9); SF-8 (PCS, MCS) | (a) Whether depression status groups at BL differed according to QoL at FU. (b) Whether depression status groups at BL differed according to QoL changes in score over time. | (a) -tests (b) Linear mixed effects regression models | (a) At 6- and 12-month FU, those with and without depression at BL differed significantly in QoL scores, with the depression group reporting lower QoL at FUs (significant for MCS and PCS). (b) While depression at BL was significantly related to improvements in MCS (but not PCS) scores over time, those with depression still reported lower QoL compared to those without. |
Heo (2008) [ ] | Depression (BDI ≥ 10); SF-36 (decrease in total score over time) | Whether FU depression is associated with a reduction in QoL over time. | Binary logistic regression | Depression at FU was associated with a significant reduction in QoL total score over time. |
Ho (2014) [ ] | Depression (according to GDS ≥ 5); SF-12 (PCS, MCS) | Whether depression at BL is associated with QoL at FU. | Linear regression | BL depression was associated with lower QoL at FU (significant for MCS and PCS). |
Hussain (2016) [ ] | Depressive disorders (SCID, MINI); current PTSD, specific phobias, other anxiety disorders (SCID, MINI); WHOQOL-Bref (general QoL and hrqol) | (a) Whether current depressive disorders at BL predict QoL at FU. (b) Whether current PTSD, specific phobias and other anxiety disorders at BL predict QoL at FU. | (a) and (b) Multiple linear regression | (a) Depressive disorders at BL predicted reduced QoL at FU (significant for general QoL and hrqol). (b) PTSD, but not specific phobias or other anxiety disorders, predicted reduced general QoL at FU. None of the anxiety disorders predicted hrqol at FU. |
Joffe (2012) [ ] | Lifetime history of depression (according to SCID); anxiety disorder (according to SCID); SF-36 (impaired QoL according to 25th percentile of SF-36; social functioning, role emotional, role physical, pain and vitality) | (a) Whether a lifetime history of depression is associated with impaired QoL during FU. (b) Whether a prior lifetime history of anxiety disorder (compared to no depression or anxiety) is associated with reduced QoL during FU. (c) Whether a lifetime history of comorbid depression and anxiety is associated with impaired QoL during FU. | (a)–(c) Repeated measure multilevel regression | (a) A history of depression only was associated with reduced QoL during FU (significant for social functioning and pain). (b) Prior lifetime history of anxiety disorder was associated with reduced QoL (significant for physical role). (c) A history of comorbid anxiety and depression was associated with reduced QoL during FU (significant for social functioning, emotional role, physical role and pain). |
Johansen (2007) [ ] | Level of PTSD symptoms according to IES-15; WHOQOL-Bref (physical health, psychological health, social relationships and environment) | Whether PTSD symptoms predict QoL at FU. | Structural equation model | More severe PTSD symptoms predicted QoL at FU (significant positive association between FU1 and FU2). |
Kramer (2003) [ ] | Current or lifetime depression/PTSD (according to Q-DIS); SF-36 (energy/fatigue, emotional role, general health, mental health, pain, physical functioning, physical role and social) | Whether QoL outcomes over time differed among the disorder groups. | Random/fixed effects model | There was no significant interaction between time and diagnostic group (no depression/PTSD, PTSD, depression and comorbid depression/PTSD) on QoL. Comparing the adjusted means for all three times among the disorder groups showed significant differences between the groups in most domains. In comparison, those with depression at BL reported reduced QoL over time in several domains compared to the PTSD group and the group without PTSD/depression. In comparison, those with PTSD only showed higher QoL compared to those with depression or comorbid depression/PTSD in several domains. |
Kuehner (2009) [ ] | Depressive symptoms (MADRS); WHOQOL (overall, physical, psychological, social and environmental) | Whether the lag in levels of depressive symptoms predicts future levels of QoL and whether the association differs by group (formerly depressed inpatients vs. community controls). | Time-lagged linear models | Higher depressive symptoms predict future lower QoL (significant for social). The association was not moderated by group status. |
Kuehner (2012) [ ] | Depression score (according to MADRS, FDD-DSM-IV); WHOQOL-Bref (physical, psychological, social and environment) | Whether the lag in depressive symptoms predicted QoL at FU. | Hierarchical, time-lagged linear models | Higher depressive symptoms significantly predicted lower QoL at FU (significant for physical and psychological). |
Lenert (2000) [ ] | Remission or persistent depression (according to DSM-III criteria, DIS); SF-12 (PCS, MCS) | Whether the remission of depression (compared to no remission) is associated with changes in QoL over time. | OLS regression | Remission of depression was associated with improved QoL (significant for MCS) at FU1 and FU2. |
Mars (2015) [ ] | Asymptomatic, mild and high symptoms of depression (according to SCAN); EQ-5D (without anxiety/depression item) | Whether depression symptom trajectories over time (asymptomatic, mild symptoms and chronic–high symptoms) are associated with QoL at FU. | Latent class growth analysis with distal outcome models | QoL at FU differed significantly among different depression symptom trajectories, with persons from the the chronic–high depressive symptom class showing lower QoL scores relative to the asymptomatic class. |
Moutinho (2019) [ ] | Depression at BL (according to DASS cut-off: 9); anxiety at BL (according to DASS anxiety scale cutoff: 7); WHOQOL-Bref at FU (physical, psychological, social and environment) | (a) Whether BL depression predicted QoL at FU. (b) Whether BL anxiety predicted QoL at FU. | (a) and (b) Stepwise linear regression | (a) Depression at BL was significantly associated with reduced QoL at FU (significant for psychological functioning, social functioning and environmental). (b) Anxiety at BL was associated with reduced QoL at FU (significant for physical). |
Ormel (1999) [ ] | Depression at BL (according to CIDI); “disability” (i.e., reduced QoL according MOS SF 6-item physical functioning scale ≥ 2) | Whether depression at BL is associated with the onset of disability (i.e., reduced QoL) during FU. | Logistic regression models | Compared to the non-depressed group, people with depression at BL showed higher odds for the onset of disability (i.e., reduced QoL) during FU (significant for 12-month FU, but not 3-month FU). |
Pan (2012) [ ] | Depressive symptoms (CES-D); WHOQOL-Bref-TW (overall score, physical, psychological, social and environmental) | Whether depressive symptoms were associated with QoL over time. | Linear mixed-effects models | Higher depressive symptoms were associated with lower QoL in MDD patients (significant for overall score, physical, psychological, social and environmental). |
Panagioti (2018) [ ] | Depressive symptoms (MHI-5); WHOQOL-Bref (physical, psychological, environmental and social) | Whether depressive symptoms at BL are associated with changes in QoL over time. | Multivariate regression models | Higher depressive symptoms at BL were associated with a decline in QoL over time (significant for physical and psychological). |
Pakpour (2018) [ ] | Dental anxiety at BL (MDAS); PedsQL 4.0 general hrqol and oral hrqol scale at FU | Whether dental anxiety at BL predicted oral- and general-health-related QoL at FU. | Structural equation modeling | Dental anxiety at BL was no significant direct predictor of generic QoL at FU and was significantly associated with worse oral-health-related QoL at FU. |
Pyne (1997) [ ] | MD-diagnosis (SCID/SADS) and depressive symptoms (HAM-D); QWB | Whether group status over time (community controls, continuously non-depressed patients, incident depression patients and continuously depressed patients) is associated with changes in QoL. | Repeated measure analysis (ANOVA) | There was no significant interaction term between group status and time, indicating that changes in QoL did not differ between the groups. At both points in time, QoL differed significantly among all groups, except between the incident depression and continuous depression group. |
Remmerswaal (2020) [ ] | OCD course (SCID), Y-BOCS, BDI, BAI over time; EQ-5D over time | (a) Whether OCD symptom severity and QoL over time were associated. (b) Whether QoL over time differs between OCD course groups (chronic, intermittent and remitting) and general population norms. (c) Whether OCD symptom severity, anxiety and depressive symptoms over time are associated with changes in QoL over time in patients with OCD. | (a) Pearson’s correlation (b)–(c) Linear mixed models | (a) QoL over time and OCD symptom severity were significantly correlated. (b) The QoL of OCD patients was significantly lower compared to general population norms, except the QoL of the intermittent OCD group at FU1, where there was no significant difference compared to the general population. When comparing the OCD course groups, the chronic OCD group had a significantly lower QoL over time compared to the other groups. The remitting group had moderately improved until FU1 and a small QoL improvement between FU1 and FU2 relative to the chronic group. (c) In those with a remitting OCD, only more severe symptoms of comorbid anxiety and depressive symptoms, but not OCD symptom severity over time, were significantly associated with a lower QoL over time. |
Rhebergen (2010) [ ] | MD-/dysthymia-/DD diagnosis at BL and subsequent recovery at FU (according to CIDI); comorbid anxiety at BL (CIDI); SF-36 (physical health summary score) | Whether QoL trajectories over time differ between: (a) different depression status groups who achieved remission (MDD, dysthymia and double depression) and a comparison group without mental health disorders. (b) The different depression status groups. (c) Whether comorbid anxiety at BL in a sample recovering from depression is associated with changes in QoL. | (a)–(c) Linear mixed models | (a) There was a significant interaction between group status and time. More specifically, compared to changes in QoL over time in people without a mental health diagnosis, QoL improved over time in those with MDD and DD, but not dysthymia. All depression diagnosis groups showed a significantly lower QoL compared to the no diagnosis group at all waves. (b) Considering the depression groups, only the interaction term between dysthymia and time until FU1 was significant. Those with dysthymia had a significantly lower QoL compared to those with MDD at FU1. This difference was not significant at FU2. (c) Comorbid anxiety disorder at BL in people who recovered from depression over time was not associated with a significant change in QoL over time. |
Rubio (2014) [ ] | First episode of incident MDD (AUDADIS-IV) at FU; incident GAD, social anxiety disorder, PD, specific phobia (AUDADIS-IV); SF-12 (MCS) | Whether incident MDD is associated with changes in QoL over time compared to: (a) people without history of MDD, (b) without history of any mental health disorder, (c) and whether the association differed by gender. Whether incident anxiety disorders are associated with changes in QoL over time: (d) compared to no history of the specific anxiety disorder, (e) compared to no history of any psychiatric disorder, (f) and whether the association differed by gender. | Linear regression model | (a) Incidence of MDD (compared to no MDD) was associated with a significant decrease in QoL until FU. (b) Incidence of MDD (compared to no mental health disorder) was associated with a significant decrease in QoL until FU. (c) The association did not vary by gender. (d) Incidence of all anxiety disorders (with comorbid disorders; ref: no history of anxiety disorder) was associated with a significant decrease in QoL over time. (e) Incident anxiety disorders were not significantly associated with QoL when only considering “pure” anxiety without any comorbidities (ref: no history of any psychiatric disorder). (f) The association did not vary by gender. |
Rubio (2013) [ ] | Remission from MDD, dysthymia (AUDADIS-IV); Remission from GAD, PD, SAD, specific phobia (AUDADIS-IV); SF-12 (MCS) | Whether remission from depression (MDD, dysthymia) is associated with: (a) changes in QoL over time (compared to non-remitted cases), (b) QoL at FU (compared to people with no history of a specific depressive disorder), (c) QoL at FU, when only considering depressive disorders without any psychiatric comorbidity (compared to people without any lifetime psychiatric diagnosis). Whether remission from anxiety disorders are associated with: (d) changes in QoL over time (compared to non-remitted cases), (e) QoL at FU (compared to people with no history of a specific anxiety disorder), (f) QoL at FU, when only considering anxiety disorders without any psychiatric comorbidity (compared to people without any lifetime psychiatric diagnosis). | (a)–(f) Linear regression models | (a) Remission from MD and dysthymia was associated with a significant positive change in QoL compared to non-remitted cases. (b) Remission of MD and dysthymia was associated with significantly lower QoL at FU compared to people without history of a specific diagnosis. (c) Remission of MD and dysthymia was associated with significantly lower QoL at FU compared to people without any lifetime psychiatric diagnosis. (d) Remission from SAD and GAD was associated with significant positive changes in QoL compared to non-remitted cases. (e) Remission of PD, SAD, specific phobia and GAD was associated with significantly lower QoL at FU compared to people without history of a specific diagnosis. (f) Remission of “pure” PD, SAD, specific phobias and GAD was associated with significantly lower QoL at FU compared to people without any lifetime psychiatric diagnosis. |
Rozario (2006) [ ] | Depressive symptoms (GDS); SF-12 (MCS and PCS) | Whether depressive symptom severity was associated with QoL change profiles over time (no change, declined and improved groups). | Multinomial logistic regression | There was no significant association between depressive symptom severity and QoL change score profiles at FU. |
Sareen (2013) [ ] | Depression trajectory groups over time (according to AUDADIS-IV); anxiety disorder trajectory groups over time (according to AUDADIS-IV); SF-12 (MCS and PCS) | (a) Whether depression trajectory groups (no past year disorder/no suicide attempt at FU, remission without treatment, persistent disorder/comorbidity/suicide attempt/treatment) differed according to QoL at FU. (b) Whether anxiety disorder trajectory groups (no past year disorder/no suicide attempt at FU, remission without treatment, persistent disorder/comorbidity/suicide attempt/treatment) differed according to QoL at FU. | (a) and (b) Multiple linear regression models | (a) QoL at FU differed among the different depression trajectory groups (MCS was significant for all groups: no disorder > remitted disorder > persistent disorder; PCS: no disorder > remitted disorder; remitted disorder < persistent disorder). (b) QoL at FU differed among the different anxiety trajectory groups (MCS was significant for all groups: no disorder > remitted disorder > persistent disorder; PCS: no disorder > persistent disorder, remitted disorder > persistent disorder). |
Shigemoto (2020) [ ] | PTSD symptoms (PCL-C); Q-LES-Q (psychosocial and physical) | Whether previous PTSD symptoms are associated with QoL at FU. | Longitudinal structural equation model | Previous PTSD symptoms were associated with physical QoL at FU1, but not FU2 or psychosocial QoL at both FUs. |
Siqveland (2015) [ ] | Depressive symptoms (according to the depression scale from the GHQ-28); PTSD symptoms (PCL-S); WHOQOL-Bref (global and hrqol) | (a) Whether depressive symptoms at BL are associated with QoL at FU. (b) Whether PTSD symptoms at BL are associated with QoL at FU. | (a) and (b) Multiple mixed effects regression analyses | (a) Higher depressive symptoms at BL were associated with reduced QoL at FU. (b) PTSD levels at BL were not significantly associated with reduced QoL at FU. |
Spijker (2004) [ ] | Depression status (CIDI); Comorbid anxiety (CIDI); SF-36 (social, role emotional) | (a) Whether depression status over time (non-depressed, recovered or depressed (including persistent, relapsing course)) is associated with QoL at FU. Whether comorbid anxiety is associated with QoL at FU (b) in a group with persistent depression and (c) in a group recovered from depression. | ANOVA | (a) QoL at FU was significantly reduced in depressed samples compared to the non-depressed group, and lower in the persistently depressed compared to the recovered group (significant for: role emotional and social). Among the depressed subgroups, there was no significant difference between a persistent or a relapsing course regarding QoL at FU. (b) In the persistently depressed group, comorbid anxiety was significantly associated with reduced QoL at FU (significant for role emotional and social). (c) In those who recovered from depression, comorbid anxiety was significantly associated with reduced QoL (significant for role emotional). |
Stegenga (2012) [ ] | MDD status according to CIDI (remitted, intermittent and chronic); SF-12 (PCS and MCS) | Whether MDD course (remitted, intermittent and chronic) is associated with QoL over time. | Random coefficient analysis | While change in QoL over time did not differ between course groups, QoL at BL (MCS) was lower in those with a chronic course compared to those who remitted from BL. |
Stegenga (2012) [ ] | MDD (CIDI); anxiety syndromes (panic disorder and others, PHQ); SF-12 (PCS) | (a) Whether MDD at BL predicts change in QoL over time. (b) Whether anxiety syndrome at BL (compared to no psychiatric diagnosis) predict changes in QoL over time. (c) Whether comorbid anxiety and MDD at BL (compared to no psychiatric diagnosis) predict changes in QoL over time. | (a)–(c) Random coefficient model | (a) While changes in QoL over time did not differ significantly between those with MDD at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with depression. (b) While changes in QoL over time did not differ significantly between those with anxiety syndrome at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with anxiety compared to those without any psychiatric diagnosis. (c) While changes in QoL over time did not differ significantly between those with comorbid anxiety and MDD at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with comorbid anxiety and MDD compared to those without any psychiatric diagnosis. |
Stevens (2020) [ ] | Posttraumatic stress symptoms (VETR-PTSD); SF-36 (MCS, PCS, physical functioning, bodily pain, general health, role physical, role emotional, mental health, vitality and social functioning) | Whether PTSS at BL is associated with QoL at FU. | Generalized estimating equations | Higher BL PTSS was significantly associated with lower QoL (PCS and MCS) at FU. Using a Bonferroni-corrected alpha value, only the domains of mental health, vitality and social functioning at FU were significantly associated with BL PTSS symptoms. The interaction between time and PTSS at BL was not significant, indicating that PTSS had the same effect on QoL outcomes at both FUs. |
Tsai (2007) [ ] | Increased post-traumatic stress symptoms (DRPST); MOS SF-36 (physical functioning, role physical, pain, general health, vitality, social functioning, role emotional, mental health, PCS and MCS) | (a) Whether different PTSS trajectory groups over time (persistent PTSS, recovered, delayed and persistently healthy) differed in QoL at FU. (b) Whether increased post-traumatic stress symptoms at BL predicted QoL at FU. | (a) ANOVA (b) Multiple regression models | (a) At FU, those who were persistently healthy had the highest QoL scores (significantly higher compared to the persistent group in all domains; significantly higher than the recovered group for: pain, general health, vitality, mental health and MCS; significantly higher compared to delayed PTSS in all domains). In addition, those with delayed PTSS (significantly lower than the recovered group in all domains except physical functioning) and those with persistent PTSS (significantly lower than recovered group in all domains) had the lowest QoL overall. (b) Increased PTSS at BL was not significantly associated with QoL at FU. |
Vulser (2018) [ ] | Depressive symptom levels (CES-D score), depression status (CES-D ≥ 19); SF-12v2 (role emotional and social) | Whether depressive symptoms or depression status at BL are associated with QoL at FU. | Generalized linear models | Both the level of depressive symptoms at BL as well as depression status at BL were associated with QoL at FU (significant for: role emotional and social). |
Wang (2000) [ ] | Depressive symptoms (SCL-90 subscale); anxiety symptoms (SCL-90 subscale); WHOQOL-Bref (total) | (a) Whether depressive symptoms at BL were associated with QoL at FU. (b) Whether anxiety symptoms at BL were associated with QoL at FU. | (a) and (b) Stepwise regression | (a) Higher depressive symptoms at BL were associated with reduced QoL at FU. (b) Anxiety symptoms BL were not included in the final stepwise regression model. |
Wang (2017) [ ] | Depressive disorder course groups (CIDI); anxiety disorder course (CIDI); SF-36 (MCS, PCS) | (a) Whether QoL at FU differs between three different course groups of depressive disorders (1. no disorder at BL and no suicide attempt until FU; 2. remitted without treatment; 3. persistent disorder/treatment/developed psychiatric co-morbidity/suicide attempt until FU). (b) Whether QoL at FU differs between three different course groups of anxiety disorders (1. no disorder at BL and no suicide attempt until FU; 2. remitted without treatment; 3. persistent disorder/treatment/developed psychiatric co-morbidity/suicide attempt until FU). | (a) and (b) Multiple linear regression | (a) Those with depression at BL that remitted without treatment had lower QoL at FU (significant for MCS and PCS) than those without the disorder and higher QoL at FU (significant for MCS) than those with a persistent disorder. (b) Those with anxiety at BL that remitted without treatment over time had lower QoL at FU than those without the disorder and higher QoL (MCS, but not PCS) than those with a persistent disorder. |
Wu (2015) [ ] | Depressive symptoms according to CDI; social anxiety symptoms (SASC); QOLS | (a) Whether depressive symptoms at BL are associated with QoL at FU. (b) Whether social anxiety symptoms at BL are associated with QoL at FU. | (a) and (b) Multivariate stepwise forward regression | (a) Higher depressive symptoms at BL were significantly associated with reduced QoL at FU. (b) Higher social anxiety symptoms at BL were not significantly associated with QoL at FU. |
Abbreviations: QoL = quality of life; MD = major depression; FU = follow-up; DSM = Diagnostic and Statistical Manual of Mental Disorders; HDRS = Hamilton Depression Rating Scale; PCS = Physical Component Score; MDS = Mental Component Score; MDD = major depressive disorder; ANOVA = analysis of variance; BL = baseline; MDE = major depressive episode; CIDI = Composite International Diagnostic Interview; SF-36 = Short Form 36; AUDADIS = Alcohol Use Disorders and Associated Disabilities Interview Schedule; SF-12 = Short Form 12; PHQ = Patient Health Questionnaire; SF-12v2: Short Form 12, Version 2; HRSD = Hamilton Rating Scale for Depression; HADS = Hospital Anxiety and Depression Scale; QLDS = Quality of Life in Depression Scale; EQ-VAS = EQ Visual Analogue Scale; DIS = Diagnostic Interview Schedule; BDI = Beck Depression Inventory; SCID = Short Children’s Depression Inventory; MINI = Mini-International Neuropsychiatric Interview; PTSD = post-traumatic stress disorder; hrqol = health-related quality of life, IES-15 = Impact of Event Scale 15; Q-DIS = Quick Version of the Mental Health’s Diagnostic Interview Schedule; MADRS = Montgomery–Åsberg Depression Rating Scale; FDD-DSM-IV = Fragebogen zur Depressionsdiagnostik nach Diagnostic and Statistical Manual of Mental Disorders IV; SCAN = Schedule for Clinical Assessment in Neuropsychiatry; DASS = Depression Anxiety Stress Scales; MOS SF = Medical Outcomes Study Short Form; CES-D = Center for Epidemiological Studies Depression Scale; WHOQOL-Bref-TW = WHOQOL-Bref Taiwan Version; MHI-5 = Mental Health Inventory 5; OCD = obsessive compulsive disorder; Y-BOCS = Yale–Brown Obsessive Compulsive Scale; BAI = Beck Angst Inventar; DD = depressive disorder; PD = psychiatric disorder; SAD = social anxiety disorder; Q-LES-Q = Quality of Life Enjoyment and Satisfaction Questionnaire; GHQ-28 = General Health Questionnaire 28; PCL-S = Post-traumatic Stress Disorder Checklist Scale; VETR-PTSD = Vietnam Era Twin Registry Posttraumatic Stress Disorder; DRPST = Disaster-Related Psychological Screening Test; SCL-90 = Symptomcheckliste bei psychischen Störungen 90; SASC = SpLD Assessment Standards Committee; QOLS = Quality of Life Scale; CDI = Children’s Depression Inventory.
Depression as independent variable and QoL as outcome. One study investigated QoL at several time points during the entire course of an episode of MD .
Buist-Bouwman, Ormel, de Graaf and Vollebergh [ 46 ] analyzed an MD group from a general population setting (NEMESIS) with data on SF-36 domains in the onset, acute and recovery phase of the depressive episode. The onset of MD was associated with a significant drop in several QoL domains and recovery with a significant increase. Pre- and post-morbid QoL levels were not significantly different for most domains, and post-morbid QoL was even higher for the psychological role functioning and psychological health domains. In comparison to a group without MD, pre- and post-morbid QoL levels in the MD group were significantly lower, except for the psychological role functioning domain, where no significant differences were found. Additionally, it should be noted that 40% of the sample had lower post-morbid QoL compared to pre-morbid levels.
Two studies investigated changes in QoL for people experiencing an onset of depression relative to different comparison groups over two points in time.
One study investigated incident MD in a general population sample (NESARC; Rubio, Olfson, Perez-Fuentes, Garcia-Toro, Wang and Blanco [ 14 ]). Here, incident MD (compared to those without a history of MD as well as to a group without any mental disorder) was associated with a significant drop in QoL (SF-12 MCS). Additionally, analyzing two waves, Pyne, Patterson, Kaplan, Ho, Gillin, Golshan and Grant [ 67 ] compared the QoL (Quality of Well-Being scale) between MD patients and community controls. The patient group was further divided into those continuously not receiving an MD diagnosis, those who continuously received the diagnosis and those who only received the diagnosis at FU (onset). The authors found that changes in QoL did not differ between the groups. At both points in time, QoL scores differed significantly between the groups, except for the incident and the continuous depression group [ 67 ].
Six studies investigated different courses of depression over time in people with depression at BL with or without a healthy comparison group as reference.
Two primary care studies analyzed groups with clinical depression at BL with different FU depression statuses (remission, no remission). One study [ 51 ] analyzed changes in generic QoL measures (SF-12, WHOQOL-Bref) and the disease-specific Quality of Life in Depression Scale. In this study, remission was associated with an improvement in all QoL domains, whereas QoL did not change significantly over time for the non-remitted group. Another study [ 60 ] investigated SF-12 MCS and PCS scores and reported a significant increase in MCS over time in the remitting group. MCS scores in the continuously depressed group and PCS scores in both groups improved, albeit not significantly.
Another study [ 47 ] investigated whether chronic MD in a general population sample (NESARC) was associated with domain-specific reduced QoL (SF-12). They found that chronic MD was a significant risk factor for persistently reduced QoL in all domains and for the onset of reduced QoL at FU in all domains except for physical role.
Two population-based studies further differentiated between the depressive disorders. Analyzing MCS scores (NESARC), Rubio, Olfson, Villegas, Perez-Fuentes, Wang and Blanco [ 15 ] reported a significant increase in QoL for those who remitted from MD and from dysthymia relative to those who had a persistent disorder. Rhebergen, Beekman, de Graaf, Nolen, Spijker, Hoogendijk and Penninx [ 69 ] differentiated between people with MD, double depression or dysthymia at BL who remitted until FU relative to a group without a mental health diagnosis (NEMESIS). Physical health (SF-36) was lowest at BL for double depression, dysthymia and then the MD group. Over time, the MD and double depression groups improved significantly in their physical health, while the dysthymia group did not improve significantly. QoL was significantly lower relative to healthy comparisons for all depression groups at all waves. There were no significant differences regarding physical health trajectories over time among the depressive disorder groups.
Stegenga, Kamphuis, King, Nazareth and Geerlings [ 75 ] investigated more than two MD course groups over time (remitted, intermittent and chronic MD) in association with SF-12 MCS and PCS over time in a primary care-recruited sample with BL MD (Predict study). MCS increased over time in all groups, while changes in PCS were small. Compared to those who remitted, MCS at BL was significantly lower for the chronic course group. While the intermittent group also displayed a lower mean MCS at BL, the coefficient was not significant.
Three studies investigated changes in depressive symptom levels as the independent variable and changes in QoL as outcomes in adults.
One study found no significant association between an initial change in depressive symptoms and subsequent change in QoL (EQ-VAS) in older adults recruited in primary care [ 21 ]. The two other studies analyzed changes in depressive symptoms in samples with MD at BL [ 50 , 51 ]. Chung, Tso, Yeung and Li [ 50 ] found that changes in depressive symptom levels was associated with changes in several QoL domains (SF-36: general health, vitality, social functioning, mental health and MCS). Diehr, Derleth, McKenna, Martin, Bushnell, Simon and Patrick [ 51 ] investigated whether quartiles of change in depressive symptoms were associated with changes in QoL (SF-12, QLDS and WHOQOL-Bref). Those without any change in depressive symptoms generally showed no change in QoL. For all QoL domains and scores except for SF-12 PCS, improvement in depressive symptoms over time was associated with a significant increase in QoL, while a reduction in depressive symptoms was associated with a significant reduction in QoL. Those who had the largest reduction in depressive symptoms also had the largest improvement in QoL measures.
Anxiety as an independent variable and QoL as an outcome. Two publications used a general population sample (NESARC) to investigate incident anxiety disorders [ 14 ] and the remission of anxiety disorders [ 15 ] in association with SF-12 MCS. Both studies separated generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD) and social phobia (SP). All incident disorders were associated with a significant reduction in QoL compared to people without a history of the specific disorders. When the analysis was restricted to incident cases without comorbidities, QoL levels were not significantly different compared to people without a history of any psychiatric disorder [ 14 ]. Those who remitted from SAD showed a significant increase in QoL compared to persistent cases. While QoL improved for all remitting anxiety disorders, change scores for PD and SP were not significant [ 15 ].
Another study investigated different courses (intermittent, chronic or remitting) of obsessive compulsive disorder (OCD) and course in QoL (EQ-5D) as well as a comparison group from the general population [ 68 ]. They found that the OCD groups mostly reported a lower QoL compared to the general population. Moreover, the course groups differed regarding their QoL over time, with remitters reporting small to moderate improvements compared to the chronic group.
One study investigated changes in anxiety symptoms in association with changes in all SF-36 domains and both summary scores over time in a sample with MD at BL [ 50 ]. Changes in anxiety symptoms were significantly associated with changes in bodily pain, general health and the mental health domain.
Additionally, we identified publications operationalizing QoL as the independent variable and anxiety/depression as outcomes with details on all studies reported in Table 3 . Only one study reported on change in QoL over time and change/trajectories in mental health outcomes over time. This study operationalized change in QoL as a predictor of future change in depressive symptoms over time and reported that an initial improvement in EQ-VAS was associated with a future reduction in depressive symptoms in older adults [ 21 ].
Studies on QoL as the independent variable and depression/anxiety as outcome.
First Author (Year) | Disorder or Symptoms Analyzed; QoL Domains Analyzed | Research Question | Methods | Results |
---|---|---|---|---|
Chou (2011) [ ] | Depressive sympt oms (CES-D-20 score); WHOQOL-Bref (total) | Whether QoL at BL is associated with depressive symptoms at FU. | Multiple regression | Lower QoL at BL was associated with higher depressive symptoms at FU. |
De Almeida Fleck (2005) [ ] | Depression status (remission vs. no complete remission, CIDI and CES-D-20 cutoff >16); QLDS, WHOQOL-Bref (physical, psychological, social and environment), SF-12 (PCS, MCS) | Whether QoL at BL is associated with course of depression (complete remission vs. non-complete remission) in a depressed sample. | Stepwise multiple logistic regression | Disease-specific QoL measure at BL significantly predicted the remission of depression at FU (significant for QLDS). |
Hajek (2015) [ ] | Depressive symptoms (GDS); EQ-VAS | Whether an initial change in QoL is associated with subsequent changes in depressive symptoms. | Vector autoregressive model | Initial changes in QoL were associated with a subsequent reduction in depression score (significant for total sample and women). |
Hoertel (2017) [ ] | MD (according to AUDADIS-IV): SF-12v2 (PCS and MCS) | Whether QoL at BL predicted recurrence (vs. remission) or persistence (vs. remission) of MD over time. | Structural equation model | Lower QoL at BL was a predictor of risk of persistence (PCS and MCS) and recurrence of MDE over time. |
Johansen (2007) [ ] | PTSD symptoms according to IES-15; WHOQOL-Bref (total) | Whether QoL predicted PTSD symptoms at FU. | Structural equation model | QoL did not significantly predict PTSD symptoms at FU. |
Kuehner (2009) [ ] | Depressive symptoms (MADRS); WHOQOL (overall, physical, psychological, social and environmental) | Whether the lag of levels of QoL predicts future levels of depressive symptoms and whether the association differs by group (formerly depressed inpatients vs. community controls) | Time-lagged linear models | Lower levels of QoL were associated with higher future depressive symptoms (significant for physical, psychological, environmental and overall). The association was not moderated by group status. |
Stegenga (2012) [ ] | MDD (CIDI); anxiety syndromes (panic disorder and others, PHQ); SF-12 (PCS) | (a) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts MDD onset over time. (b) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts anxiety syndrome onset over time. (c) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts onset of comorbid anxiety and MDD over time. | (a)–(c) Multinomial logistic regressions | (a) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of MDD over time in the sample of people without a diagnosis at BL (significant for severely reduced QoL). (b) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of anxiety syndrome over time in the sample of people without a diagnosis at BL (significant for moderately and severely reduced QoL). (c) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of comorbid anxiety and depression over time in the sample of people without a diagnosis at BL (significant for mild, moderately and severely reduced QoL). |
Wu (2016) [ ] | Elevated social anxiety symptoms (SASC cutoff 9); QOLS | Whether QoL is associated with changes in elevated social anxiety symptoms over time. | Generalized Estimating Equation | Higher QoL was associated with a decreased risk for developing elevated social anxiety symptoms over time. |
Wu (2017) [ ] | Elevated depressive symptoms (according to CDI ≥19); QOLS | Whether QoL at BL is associated with elevated depressive symptoms at FU. | Multiple stepwise logistic regression | QoL at BL was not significantly related to depressive symptoms at FU. |
Abbreviations: CES-D-20 = Center for Epidemiological Studies Depression Scale 20; BL = baseline; FU = follow-up; QoL = quality of life; CIDI = Composite International Diagnostic Interview; QLDS = Quality of Life in Depression Scale; SF-12 = Short Form 12; PCS = Physical Component Score; MCS = Mental Component Score; GDS = Geriatric Depression Scale; EQ-VAS = EQ Visual Analogue Scale; MD = mental disorder; AUDADIS-IV = Alcohol Use Disorders and Associated Disabilities Interview Schedule; SF-12v2 = Short Form 12 Version 2; PTSD = post-traumatic stress disorder; IES-15 = Impact of Event Scale 15; MADRS = Montgomery–Åsberg Depression Rating Scale; MDD = major depressive disorder; PHQ = Patient Health Questionnaire; SASC = SpLD Assessment Standards Committee; QOLS = Quality of Life Scale; CDI = Children’s Depression Inventory.
In total, eight studies on adults were included in a supplementary meta-analyses of several research questions on SF PCS and MCS in association with anxiety and depressive disorders. Forest plots for the analyses are provided in the supplementary materials (Figures S1–S10) .
Differences in SF summary scores at FU among adults with and without depressive disorders at BL. Based on a pooling of four studies [ 45 , 49 , 52 , 54 ], those with depression at BL showed lower MCS scores at FU compared to a group without depression at BL with a large effect size (SMD = −0.96, 95% CI: −1.04 to −0.88, p < 0.001, I 2 = 0.0%). PCS scores at FU were lower for the depression group compared to the non-depression group with a medium effect size (SMD = −0.68, 95% CI: −1.06 to −0.30, p < 0.001, I 2 = 94.6%). Excluding the study rated “poor” in the quality/risk of bias assessment from the pooling did not substantially affect the results (MCS: SMD = −0.96, 95% CI: −1.03 to −0.88, p < 0.001, I 2 = 0.01%; PCS: SMD = −0.63, 95% CI: −1.08 to −0.19, p < 0.01, I 2 = 96.8%).
BL differences in SF summary scores among adults with MD at BL with and without remitting courses over time. Based on a pooling of two studies [ 19 , 84 ] of samples with MD at BL, those with persistent MD at FU had significantly lower MCS at BL (SMD = −0.25, 95% CI: −0.41 to −0.10, p = 0.001, I 2 = 74.95) and PCS scores at BL (SMD = −0.24, 95% CI: −0.39 to −0.09, p = 0.002, I 2 = 73.14) compared to those who achieved remission until FU. Effect sizes were small for both summary scores.
FU differences in SF summary scores among adults with depressive and anxiety disorders at BL with and without remitting courses . Based on the pooling of two studies [ 71 , 81 ] of samples with MD and/or dysthymia, the group where the disorder had persisted/a co-morbid condition was present/had a suicide attempt until FU had significantly lower MCS scores at FU compared to the group where the disorder had remitted without treatment until FU, with a medium effect size for depressive disorders (SMD = −0.59, 95% CI: −0.75 to −0.42, p < 0.001, I 2 = 37.72) and a small effect size for anxiety disorders (SMD = −0.44, 95% CI: −0.58 to −0.30, p < 0.001, I 2 = 58.87). The SMD for PCS scores at FU was negligible in terms of effect size for both disorder groups (depressive disorders: SMD = 0.02, 95% CI: −0.24 to 0.27, p = 0.90, I 2 = 73.65; anxiety disorders: SMD = −0.09, 95% CI: −0.17 to −0.01, p = 0.03, I 2 = 0.01).
4.1. main results.
This review adds to the present literature by providing an overview of longitudinal observational studies investigating the association between depression, anxiety and QoL in samples without other specific illnesses or specific treatments. Additional meta-analyses investigated group differences according to SF MCS and PCS.
While a concise synthesis of all the identified studies is challenging due to heterogeneity, the following picture emerges from studies investigating change–change associations: before the onset of disorders, QoL is already lower in disorder groups in comparison to healthy comparisons. The onset of the disorders further reduces the QoL. Remission is associated with an increase in QoL, mostly to pre-morbid levels. Additionally, some studies show that remission patterns are relevant for QoL outcomes as well. Moreover, a bi-directional effect was reported, whereby QoL is also predictive of mental health outcomes.
Evidence for a bi-directional association as well as studies showing lower QoL across the entire course of the disorders (before onset, during disorder, after disorder) relative to a healthy comparison group seem to suggest that impairments in QoL may result from a certain pre-disorder vulnerability in these groups. Longitudinal studies using general population data have investigated different hypotheses on (QoL) impairments after remission of anxiety disorders and MD [ 87 , 88 ]. One hypothesis suggests that impairments after the illness episode reflect a pre-disorder vulnerability (vulnerability or trait hypothesis), while the another states that impairments develop during the mental health episode and remain as a residual after recovery (scar hypothesis). Generally, both studies favored the vulnerability hypothesis [ 87 , 88 ]. For subgroups with recurrent anxiety disorders, scarring effects were also found for mental functioning [ 88 ]. Yet, it has to be noted that it was not the aim of our review to gather evidence for these hypotheses using QoL as an indicator, which represents an opportunity for future research.
To be able to investigate possible domain-specific differences across studies, we aimed to conduct a meta-analysis on all studies on the same research question which reported on QoL subdomains (e.g., using WHOQOL and SF). However, as described in the Methods section above, only eight studies reported comparable information on different research questions and could be included in meta-analyses. Due to the limited number of studies included in each meta-analysis, the focus on SF MCS and PCS scores, and most studies reporting on depression, the results of the meta-analyses should be viewed with caution. Keeping this in mind, our results indicate that both mental and physical QoL are significantly impacted by anxiety and depressive disorders and that the course of the disorder is also relevant for QoL outcomes. Not surprisingly, effect sizes for MCS were larger compared to PCS for most research questions. A pooling of two studies on different courses of anxiety and depressive disorders found that effect sizes for MCS at FU were of moderate size for depressive (SMD = −0.59) and of small size for anxiety disorders (SMD = −0.44), while SMDs for PCS at FU were negligible in size.
Overall, effect sizes from meta-analyses ranged from negligible to large, and heterogeneity varied considerably (I 2 between 0% and 95%). Because of the small number of studies, possible influential study-level factors (e.g., setting, operationalization of the variables, length of FU) could not be investigated in further detail by means of a meta-regression, which remains a question for future research.
Based on the results described and study heterogeneity discussed above, we provide recommendations for future research.
First recommendation: future research should differentiate between individual disorders and focus on anxiety disorders. The majority of the studies investigated depressive disorders or symptoms. On the level of individual disorders, most focused on MD, while two studies additionally reported on dysthymia [ 15 , 69 ]. One of these investigated double depression [ 69 ]. On the level of anxiety disorders, three publications differentiated between individual anxiety disorders within the same study [ 14 , 15 , 63 ]. While it was not possible to conduct a meta-analysis comparing different anxiety disorders in our case, individual studies suggest possible disorder-specific differences when analyzing changes in QoL over time: Rubio, Olfson, Villegas, Perez-Fuentes, Wang and Blanco [ 15 ] suggest that QoL significantly improved for those remitting from GAD and SAD (compared to non-remission). QoL improved for PD and SP as well, but differences in change scores were smaller and did not reach statistical significance. The incidences of all of these disorders were associated with a significant drop in QoL [ 14 ]. In summary, future longitudinal studies should focus on anxiety disorders and generally differentiate between individual disorders to investigate possible disorder-specific differences.
Second recommendation: future research should consider trajectories of disorders/change in symptoms and changes in QoL over time. We would have liked to include a meta-analysis of disorder trajectories and change scores in QoL over time. Because of the small, diverse number of studies on this association in general and the number of assumptions that would have had to have been made for a meta-analysis, we refrained from pooling effects for this research question. In total, 17 studies investigated changes in independent variables associated with changes in outcomes. This approach has several advantages. On the one hand, different disorder or symptom trajectories can be identified. Several studies reported that QoL outcomes differ according to disorder course and the degree of change in symptoms. The focus on the change in characteristics over time in future research could additionally reduce the problem of unobserved time-constant heterogeneity in observational studies when appropriate methods are applied [ 26 ].
Third recommendation: future research should investigate individual QoL domains. Several systematic reviews on cross-sectional studies found that effect sizes differed by QoL domains [ 32 , 89 ]. For example, Olatunji, Cisler and Tolin [ 89 ] reported that health and social functioning were most impaired for anxiety disorders (compared to non-clinical controls). Comparing individuals with diabetes and depressive symptoms to those with diabetes only, Schram, Baan and Pouwer [ 32 ] reported that while SF pain scores were mild to moderately impaired, role and social functioning displayed moderate to severe impairments in those with comorbid depressive symptoms. The other scores were moderately impaired. As described above in detail, a meta-analysis using all subdomains was not feasible in this review. Further research differentiating between QoL domains would thus allow future meta-analyses to investigate whether the observed domain-specific differences reported in previous reviews of cross-sectional data can be observed in longitudinal studies as well.
Fourth recommendation: future research should consider bi-directional effects. While investigating QoL as the outcome measure and anxiety/depression as independent variables seems relatively straightforward, ten studies investigated QoL as the independent variable and anxiety/depression as outcomes. In light of possible bi-directional effects and pre-existing vulnerability suggested by individual studies, future research considering QoL as an independent variable could inform a deeper understanding of this complex association.
A strength of this work is the transparent methodological process: the review was prospectively registered with PROSPERO and a study protocol was published [ 34 ]. Two reviewers were included in screening, data extraction and quality assessment processes. There were no limitations regarding the time or location of the publications. Moreover, all versions of the ICD/DSM and validated questionnaires were considered eligible to identify anxiety or depression. Another strength is the thorough literature search that enabled us to identify all relevant studies. Additionally, we did not limit the age range and were therefore able to shed light on studies investigating children/adolescents. Moreover, some studies could be pooled using random-effects meta-analyses, which allows for stronger conclusions regarding effect sizes compared to individual studies. Besides the content analysis, this review emphasizes difficulties in meta-analysis from observational, longitudinal studies. We hope that our work can facilitate discussion on this topic.
The study has some limitations. We did not limit our search to specific research questions, which led to the inclusion of heterogeneous studies. Heterogeneity particularly stemmed from the operationalization of the variables of interest. Due to this, a concise narrative synthesis of all results was not feasible. The positive aspect of this broad focus is that it allowed us to provide an overview of studies and research questions analyzed and to formulate more nuanced recommendations for future research. We have to acknowledge that there is an abundance of QoL assessments used in medicine and health sciences [ 37 ]. The list applied in this work was derived with respect to previous relevant reviews on QoL research. It was not designed to be fully comprehensive or exhaustive. Rather, it provided us with a working definition for this review and helped to enhance the transparency of our selection processes. Additionally, because we included validated QoL measures frequently used in research, we assume that exclusion would particularly have been the case for novel or study-specific measures. Finally, the focus on peer-reviewed literature means that studies in other languages and gray literature were not considered. Nonetheless, this focus on literature published in peer-reviewed journals should ensure a certain scientific quality.
Overall, the results indicate that QoL is lower before the onset of anxiety and depressive disorders, further reduces upon onset of the disorders and generally improves with remission to pre-morbid levels. Moreover, disorder course (e.g., remitted, intermittent, chronic) seems to play an important role; however, only a few studies analyzed this. Changes in anxiety and depressive symptoms were also associated with changes in QoL over time. Meta-analyses found that effect sizes were larger for MCS relative to PCS, highlighting the relevance of differentiation between QoL domains. While our review identified some gaps in the current literature and made recommendations for future research, the following should be noted for clinical practice. On the one hand, an improvement in mental health is associated with better QoL, which emphasizes the relevance of support during the disorders. This is also shown by meta-analyses, which show that cognitive behavioral therapy additionally improves QoL [ 90 , 91 ]. Moreover, the results indicate reduced QoL even before disorder onset, highlighting the relevance of early preventive measures in vulnerable groups. In line with this, studies on school-based prevention programs show a significant reduction in anxiety and depressive symptoms [ 92 , 93 ], and psychosocial prevention programs may additionally improve QoL [ 94 ].
During the COVID-19 pandemic, it is of high relevance to tackle the arising challenges associated with this pandemic. For example, it is important to face the high prevalence rates of both depression and anxiety with appropriate measures.
The authors would like to thank Elzbieta Kuzma for her consultation (Albertinen-Haus Centre for Geriatrics and Gerontology, University of Hamburg, Hamburg, Germany; University of Exeter Medical School, Exeter, UK).
The following are available online at https://www.mdpi.com/article/10.3390/ijerph182212022/s1 , Table S1: detailed descriptive information for included studies ( n = 47); Figure S1: forest plot for differences in SF MCS at FU among adults with and without depressive disorders at BL; Figure S2: forest plot for differences in SF PCS at FU among adults with and without depressive disorders at BL; Figure S3: forest plot for differences in SF MCS at FU among adults with and without depressive disorders at BL (sensitivity analysis); Figure S4: forest plot for differences in SF PCS at FU among adults with and without depressive disorders at BL (sensitivity analysis); Figure S5: forest plot for BL differences in SF MCS among adults with MD at BL with and without remitting courses over time; Figure S6: forest plot for BL differences in SF PCS among adults with MD at BL with and without remitting courses over time; Figure S7: forest plot for FU differences in SF MCS among adults with depressive disorders at BL with and without remitting courses; Figure S8: forest plot for FU differences in SF PCS among adults with depressive disorders at BL with and without remitting courses; Figure S9: forest plot for FU differences in SF MCS among adults with anxiety disorders at BL with and without remitting courses; Figure S10: forest plot for FU differences in SF PCS among adults with anxiety disorders at BL with and without remitting courses.
J.K.H.: conceptualization of research question; development of search strategy; study screening and selection; risk of bias/quality assessment; study synthesis; writing—original draft, review and editing; H.-H.K.: conceptualization of research question; writing—review and editing; E.Q.: study screening and selection; risk of bias/quality assessment; writing—review and editing; A.H.: conceptualization of research question; development of search strategy; study screening and selection (third party); study synthesis; writing—review and editing. All authors have read and agreed to the published version of the manuscript.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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The authors declare no conflict of interest.
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Home — Essay Samples — Nursing & Health — Psychiatry & Mental Health — Anxiety
Anxiety essay topic examples, argumentative essays.
Argumentative essays on anxiety require you to take a stance on a specific aspect of anxiety and provide evidence to support your viewpoint. Consider these topic examples:
Example Introduction Paragraph for an Argumentative Anxiety Essay: Anxiety is a prevalent mental health concern that affects individuals of all ages. In this argumentative essay, we will explore the significance of introducing comprehensive mental health education in schools and its potential to alleviate anxiety among students.
Example Conclusion Paragraph for an Argumentative Anxiety Essay: In conclusion, the argument for incorporating mental health education in schools underscores the need to address anxiety and related issues at an early stage. As we advocate for change, we are reminded of the positive impact such initiatives can have on the well-being of future generations.
Compare and contrast essays on anxiety involve analyzing the similarities and differences between various aspects of anxiety, treatment approaches, or the impact of anxiety on different demographic groups. Consider these topics:
Example Introduction Paragraph for a Compare and Contrast Anxiety Essay: Anxiety manifests in various forms, affecting individuals differently. In this compare and contrast essay, we will examine the experiences and coping strategies of individuals with generalized anxiety disorder (GAD) and social anxiety disorder (SAD), shedding light on the distinctions and shared aspects of their conditions.
Example Conclusion Paragraph for a Compare and Contrast Anxiety Essay: In conclusion, the comparison and contrast of GAD and SAD provide valuable insights into the diverse landscape of anxiety disorders. As we deepen our understanding, we can better tailor support and interventions for those grappling with these challenges.
Descriptive essays on anxiety allow you to provide a detailed account of anxiety-related experiences, the impact of anxiety on daily life, or the portrayal of anxiety in literature and media. Here are some topic ideas:
Example Introduction Paragraph for a Descriptive Anxiety Essay: Anxiety can be a formidable adversary, but it is also a source of resilience and personal growth. In this descriptive essay, I will recount a deeply personal journey of overcoming a significant anxiety-related challenge, shedding light on the emotions and strategies that guided me along the way.
Example Conclusion Paragraph for a Descriptive Anxiety Essay: In conclusion, my personal narrative of conquering anxiety illustrates the transformative power of resilience and determination. As we share our stories, we inspire others to confront their fears and embrace the path to recovery.
Persuasive essays on anxiety involve advocating for specific actions, policies, or changes related to anxiety awareness, treatment accessibility, or destigmatization. Consider these persuasive topics:
Example Introduction Paragraph for a Persuasive Anxiety Essay: Anxiety affects millions of individuals, yet stigma and limited resources often hinder access to necessary support. In this persuasive essay, I will make a compelling case for the expansion of mental health services on college campuses, emphasizing the benefits to students' overall well-being and academic success.
Example Conclusion Paragraph for a Persuasive Anxiety Essay: In conclusion, the persuasive argument for increased mental health resources on college campuses highlights the urgent need to prioritize students' mental well-being. As we advocate for these changes, we contribute to a more inclusive and supportive educational environment.
Narrative essays on anxiety allow you to share personal stories, experiences, or perspectives related to anxiety, your journey to understanding and managing it, or the impact of anxiety on your life. Explore these narrative essay topics:
Example Introduction Paragraph for a Narrative Anxiety Essay: Anxiety is a deeply personal experience that can profoundly impact one's life. In this narrative essay, I will take you through a vivid account of a panic attack I experienced, offering insights into the physical and emotional aspects of this anxiety-related event.
Example Conclusion Paragraph for a Narrative Anxiety Essay: In conclusion, the narrative of my panic attack experience underscores the importance of self-awareness and coping strategies in managing anxiety. As we share our stories, we foster understanding and support for those facing similar challenges.
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Anxiety is a psychological and physiological response characterized by feelings of apprehension, fear, and unease. It is a natural human reaction to perceived threats or stressors, triggering a heightened state of arousal and activating the body's fight-or-flight response.
Excessive worrying: Individuals with anxiety often experience persistent and intrusive thoughts, excessive worrying, and an inability to control their anxious thoughts. Physical symptoms: Anxiety can manifest physically, leading to symptoms such as increased heart rate, rapid breathing, sweating, trembling, muscle tension, headaches, and gastrointestinal disturbances. Restlessness and irritability: Anxiety can cause a sense of restlessness and irritability, making it difficult for individuals to relax or concentrate on tasks. Sleep disruptions: Anxiety has the potential to interfere with sleep patterns, resulting in challenges when trying to initiate sleep, maintain it, or achieve a restorative sleep. Consequently, this can exacerbate feelings of fatigue and weariness. Avoidance behaviors: People with anxiety may engage in avoidance behaviors, such as avoiding certain situations or places that trigger their anxiety. This can restrict their daily activities and limit their quality of life.
Genetic predisposition: Research suggests that individuals with a family history of anxiety disorders may have a higher likelihood of developing anxiety themselves. Certain genetic variations and inherited traits can increase susceptibility to anxiety. Brain chemistry: Imbalances in neurotransmitters, such as serotonin, dopamine, and gamma-aminobutyric acid (GABA), are thought to play a role in anxiety disorders. These chemical imbalances can affect the regulation of mood, emotions, and stress responses. Environmental factors: Traumatic life events, such as abuse, loss, or significant life changes, can trigger or exacerbate anxiety. Chronic stress, work pressure, and relationship difficulties can also contribute to the development of anxiety. Personality traits: Certain personality traits, such as being prone to perfectionism, having a negative outlook, or being highly self-critical, may increase the risk of developing anxiety disorders. Medical conditions: Certain medical conditions, such as thyroid disorders, cardiovascular issues, and respiratory problems, can be associated with anxiety symptoms.
Generalized Anxiety Disorder (GAD): GAD is marked by excessive and uncontrollable worry about various aspects of life, including work, health, and everyday situations. Individuals with GAD often experience physical symptoms like restlessness, fatigue, muscle tension, and difficulty concentrating. Panic Disorder: Panic disorder involves recurrent and unexpected panic attacks, which are intense episodes of fear accompanied by physical symptoms like rapid heart rate, shortness of breath, chest pain, and dizziness. People with panic disorder often worry about future panic attacks and may develop agoraphobia, avoiding places or situations that they fear might trigger an attack. Social Anxiety Disorder (SAD): SAD is characterized by an intense fear of social situations and a persistent worry about being embarrassed, judged, or humiliated. People with SAD may experience extreme self-consciousness, avoidance of social interactions, and physical symptoms like blushing, trembling, or sweating. Specific Phobias: Common examples include phobias of heights, spiders, flying, or enclosed spaces. Exposure to the feared object or situation can trigger severe anxiety symptoms. Obsessive-Compulsive Disorder (OCD): OCD is characterized by intrusive and unwanted thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety. Common obsessions include fears of contamination, doubts, and a need for symmetry, while common compulsions include excessive cleaning, checking, and arranging.
The treatment of anxiety typically involves a multi-faceted approach aimed at addressing the individual's specific needs. One common form of treatment is psychotherapy, which involves talking with a trained therapist to explore the underlying causes of anxiety and develop coping strategies. Cognitive-behavioral therapy (CBT) is often employed to challenge negative thought patterns and behaviors associated with anxiety. In some cases, anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, may be prescribed by a healthcare professional. These medications work to alleviate the intensity of anxiety symptoms and promote a sense of calm. Additionally, lifestyle modifications can play a significant role in anxiety management. Regular exercise, stress-reduction techniques like meditation or yoga, and maintaining a balanced diet can contribute to overall well-being and help alleviate anxiety symptoms.
1. Anxiety disorders are highly prevalent mental health conditions that affect a substantial number of individuals worldwide, impacting approximately 284 million people globally. 2. Research indicates that women have a higher likelihood of being diagnosed with anxiety disorders compared to men. Studies reveal that women are twice as likely to experience anxiety, with this gender difference emerging during adolescence and persisting into adulthood. 3. Anxiety disorders often coexist with other mental health issues. Extensive research has demonstrated a strong correlation between anxiety disorders and comorbidities such as depression, substance abuse, and eating disorders. These co-occurring conditions can significantly impact an individual's well-being and require comprehensive and integrated approaches to treatment.
Anxiety is an important topic to explore in an essay due to its widespread impact on individuals and society as a whole. Understanding and addressing anxiety is crucial for several reasons. Firstly, anxiety disorders are highly prevalent, affecting a significant portion of the population globally. This prevalence highlights the need for increased awareness, accurate information, and effective strategies for prevention and treatment. Secondly, anxiety can have profound effects on individuals' mental, emotional, and physical well-being. It can impair daily functioning, hinder relationships, and limit personal growth. By delving into this topic, one can examine the various factors contributing to anxiety, its symptoms, and the potential consequences on individuals' lives. Additionally, exploring anxiety can shed light on the complex interplay between biological, psychological, and social factors that contribute to its development and maintenance. This understanding can inform the development of targeted interventions and support systems for individuals experiencing anxiety.
1. Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327-335. 2. Kessler, R. C., et al. (2005). Lifetime prevalence and age-of-onset distributions of anxiety disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. 3. National Institute of Mental Health. (2018). Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/ 4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. 5. Craske, M. G., et al. (2017). Anxiety disorders. Nature Reviews Disease Primers, 3(1), 17024. 6. Hofmann, S. G., et al. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440. 7. Roy-Byrne, P. P., et al. (2010). Treating generalized anxiety disorder with second-generation antidepressants: A systematic review and meta-analysis. Journal of Clinical Psychiatry, 71(3), 306-317. 8. Etkin, A., et al. (2015). A cognitive-emotional biomarker for predicting remission with antidepressant medications: A report from the iSPOT-D trial. JAMA Psychiatry, 72(1), 14-22. 9. Heimberg, R. G., et al. (2014). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. JAMA, 293(23), 2884-2893. 10. Hofmann, S. G., et al. (2013). Efficacy of cognitive behavioral therapy for social anxiety disorder: A meta-analysis. Psychological Medicine, 43(05), 897-910.
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A major aim of this course was to shed some light on the aetiology of depression and anxiety. At the end of it you should have some idea of the complexity of this enterprise. We have focused on one of the best-studied and hence best-understood contributors to psychopathology – stress. This has biological, social and psychological significance, and its operation can be studied and understood at all these levels.
The clear message you should take away is that interaction between these levels is enormously important in aetiology. Biological factors, such as dysregulation of the HPA axis and its consequences, possible abnormalities in brain neurotransmitter systems, the effects of stress on the developing brain at different ages, and the kinds of genes that an individual carries, appear to play an important part in the development and maintenance of emotional disorders such as depression and anxiety. However, these biological factors cannot be divorced from factors that are thought of as psychosocial, such as abuse in childhood, or stressful events and how we perceive them. This is very evident from the most recent developments in genetics, which show how, via epigenetic processes, experiences are translated into the activity (or expression) of genes, which then modify the workings of the brain in ways that affect mood.
Research into epigenetic influences on mental health and ill-health is burgeoning and is likely to make a very significant contribution to our understanding of aetiology in the years to come. If so, it should also help clarify how existing treatments, both pharmacological and psychotherapeutic, for emotional disorders work, or suggest new approaches that would work more effectively.
The HPA axis is overactive in those with depression and anxiety, suggesting a role for chronic stress. Elevated levels of glucocorticoids such as cortisol and corticosterone, resulting from chronic stress, have toxic effects in some areas of the brain and promote neurogenesis in others.
The monoamine hypothesis of mood disorders has been influential in trying to explain the causes of depression. However the picture is now more complex and the view of a simple chemical imbalance as a cause of depression is outdated.
Hypotheses such as the neurotrophic hypothesis and the network hypothesis have been developed to try to account for the complex effects of antidepressant treatments on the brain.
The life-cycle model of stress links brain development with stress effects over the lifetime.
The cognitive approach concentrates on particular ways of thinking and how these cause and sustain depression.
Genetic and other vulnerabilities (also called predispositions or diatheses) can interact with environmental factors, which include psychosocial stressors such as stressful life events and early life stress (including child abuse) to cause emotional disorders such as depression.
Epigenetic processes add another layer of complexity to the interaction between genes and environment. There is increasingly evidence of the importance of epigenetic processes in the aetiology of mood disorders.
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Did you know according to the National Institute of Mental Health; it is estimated that approximately 8.4% of adults are patients of major depression in the US? Well, depression is a common illness globally that affects a lot of people. Yet, the reasons for this psychological sickness vary from person to person and numerous studies are being conducted to discover more about depression.
Therefore, college and university students are currently assigned to write research papers, dissertations, essays, and a thesis about depression. However, writing essays on such topics aims to increase the awareness of physical and mental well-being among youth and help them find solutions.
However, a lot of students find it pretty challenging to write a thesis statement about depression and seek someone to write my essay . No worries! In this article, you will learn about what is a good thesis statement about mental health and some effective methods and approaches to write a killer headline and compose an astonishing essay about depression.
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A thesis is the overview of the concepts and ideas that you will write in your research paper or in the essay. Yet, a thesis statement about anxiety focuses more on the stress and depression topics for the paper you’re working on, which can be written by following the tips given below.
Nonetheless, you can compose an outline by covering the points mentioned below:
1. Pick a good study topic and perform a basic reading. Look for some intriguing statistics and try to come up with creative ways to approach your subject. Examine a few articles for deficiencies in understanding.
2. Make a list of your references and jot down when you come across a noteworthy quotation. You can cite them in your paper as references. Organize all of the information you’ve acquired in one location.
3. In one phrase, state the purpose of your essay. Consider what you want to happen when other people read your article.
4. Examine your notes and construct a list of all the key things you wish to emphasize. Make use of brainstorming strategies and jot down any ideas that come to mind.
5. Review and revise the arguments and write a thesis statement for a research paper or essay about depression.
6. Organize your essay by organizing the list of points. Arrange the points in a logical sequence. Analyze all elements to ensure that they are all relevant to your goal.
7. Reread all of your statements and arrange your outline in a standard manner, such as a bulleted list.
So, what is an ideal way to write a thesis statement about depression for your research paper or essay? We hope you have a thorough idea of the essay you’re writing before picking a thesis statement about mental well-being. That will assist you in developing the greatest thesis for our essay.
But don’t get too worked up over your thesis statement for a research paper on mental disorders. Our professional subject experts have produced a list of thesis statements about mental health and depression themes for research paper writing, so you’ve got your job cut out for you. For your essay assignments or assignments, we will also offer appropriate thesis statements.
If you’re still confused about which statement to use, contact us right away. We have a staff of highly qualified and seasoned writers who can assist you with your essay or research work and guarantee that you receive the highest possible score.
Students are often asked to write an essay on Anxiety And Depression in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.
Let’s take a look…
Anxiety and depression: an overview.
Anxiety and depression are mental health issues. Both can make a person feel sad or worried. Anxiety can make you feel scared or nervous. Depression can make you feel very sad for a long time. Both can make it hard to do everyday things.
Signs and symptoms.
Signs of anxiety and depression can be different for everyone. Some people might not want to do things they usually enjoy. They might feel tired all the time, have trouble sleeping, or eat too much or too little.
If you think you have anxiety or depression, it’s important to talk to someone you trust about it. This could be a parent, teacher, or friend. They can help you find a doctor or counselor who can help.
250 words essay on anxiety and depression, understanding anxiety and depression.
Anxiety and depression are mental health issues that affect many people. Anxiety makes you feel worried or scared. Depression makes you feel sad and lose interest in things you once enjoyed.
These conditions can be caused by many things. It could be due to a tough situation at home or school, like bullying. Sometimes, it might be because of chemical changes in the brain. It’s important to remember that it’s not anyone’s fault if they have these conditions.
People with anxiety might feel nervous, have a hard time sleeping, or find it difficult to focus. Those with depression might feel tired all the time, have trouble sleeping, or not want to eat. They might also feel sad or hopeless.
If you or someone you know is dealing with these feelings, it’s important to get help. This could be talking to a trusted adult, like a parent or teacher. They can help find a doctor or counselor who knows how to deal with these issues.
Anxiety and depression are serious, but help is available. It’s okay to ask for help, and it’s important to take care of your mental health. Remember, you’re not alone, and there are people who want to help.
What is anxiety and depression, why do people get anxiety and depression.
There are many reasons why someone might feel anxious or depressed. Sometimes, it’s because of something that happened in their life, like moving to a new school or losing a loved one. Other times, it might be because of changes in the brain. It’s important to remember that it’s not the person’s fault. Just like you can’t control if you get a cold, you can’t control if you have anxiety or depression.
Anxiety and depression can show up in different ways. Someone with anxiety might have a hard time sleeping or feel their heart beating really fast. They might worry a lot about things that could go wrong. A person with depression might feel tired all the time or have a hard time getting out of bed. They might not want to hang out with friends or do things they usually like.
How can we support people with anxiety and depression.
In conclusion, anxiety and depression are serious but common mental health issues. They can make people feel scared, worried, or sad for long periods. But with the right help and support, people with anxiety and depression can feel better. If you or someone you know is struggling, it’s important to reach out to a mental health professional.
Apart from these, you can look at all the essays by clicking here .
Happy studying!
Methods section.
Education is expected to have appositive importance on the student’s life by enhancing their capability to think and improving their competency. However, it often acts as a source of stress that affects students’ mental health adversely. This causation of academic stress often emanates from the need to have high grades, the requirement to change attitude for success, and even pressures put by various school assignments.
These pressures introduced by education can make the student undergo a series of anxiety, depression, and stress trying to conform to the forces. The causes of academic stress are well-researched but there is still no explanation why the rate of strain increases despite some measures being implemented to curb student stress. This research explores this niche by using 100 participants who study at my college.
Nowadays there are many reasons that cause stress among growing number of students who might not know they are going through the condition most of the time. Hence, undiscovered discouragement or uneasiness can cause understudies to feel that they are continually passing up unique open doors. It prompts substance misuse; self-destruction is the second most typical reason for death among undergrads. The main hypothesis of this article is that college and university students have higher depression rates.
This proposal undercovers how the problem of anxiety and depression is progressing if not addressed. With such countless youngsters experiencing undiscovered tension, it may be challenging for them to appreciate school. Understudies’ emotional well-being is risked when pressure and trouble go unnoticed, which can prompt social and educational issues (Nelson & Liebel, 2018). Educators might battle to perceive uneasiness since these circumstances manifest themselves contrastingly in different people.
Anxiety and depression are complicated disorders with numerous elements that impact people differently. Teachers and staff must be well trained to deal with these unforeseen events. Understudies coming to college come from various financial foundations, which can prompt an assortment of psychological wellness chances (Li et al., 2021). Additionally, current works will be evaluated to differentiate the risk factors associated with stress among university undergraduates worldwide.
There are various reasons which might cause the onset of anxiety and depression. It can be absence of rest, terrible dietary patterns, and lack of activity add to the gloom in undergrads (Ghrouz et al., 2019). Scholarly pressure, which incorporates monetary worries, strain to track down a decent profession after graduation, and bombed connections, is sufficient to drive a few understudies to exit school or more awful.
Numerous parts of school life add to despondency risk factors. For example, understudies today are owing debtors while having fewer work prospects than prior. Discouraged kids are bound to foster the problems like substance misuse (Lattie et al., 2019). For adaptation to close-to-home trouble, discouraged understudies are more inclined than their non-discouraged companions to knock back the firewater, drink pot, and participate in unsafe sexual practices.
The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018). Anxiety is one of the most critical indicators of academic success, it shows how students’ attitudes change, reflecting on their overall performance.
The study will use college students who are joining and those already in college. The research period is planned to last six months; college students are between the ages of 18 and 21 and life is changing rapidly at this age (Spillebout et al., 2019). This demography will come from the college where I study. The participants will be chosen randomly, the total number will be 100, both female and male, and from all races.
Some of the materials to be used in the study will include pencils, papers, and tests. Paper and pencils are typical supplies that students are familiar with, so using them will not cause additional stress. It will be used during the interview with the students and throughout the study will be in effect (Huang et al., 2018). These have been applied in various studies before, and, hence, they will be instrumental in this study.
The study will follow a step-wise procedure to get the required results. First, the students’ pre-depression testing results would be researched and recorded. Second, the students would undergo standardized testing in the same groups. Scholarly accomplishment is impacted by past intellectual performance and standardized testing (Chang et al., 2020). Third, the students’ levels of depression and anxiety would be monitored along with their test results.
The study will use a descriptive, cross-sectional design with categorical and continuous data. The sample demographic characteristics were described using descriptive statistics. Pearson’s proportion of skewness values and common mistakes of skewness was utilized to test the ordinariness of the persistent factors. The distinctions in mean scores between sociodemographic variables and stress will be examined using Tests (Lipson et al., 2018). The independent variable will be essential because it will provide the basis of measurement.
The 100 participants had different anxiety levels, as seen from the Test taken and the various evaluations. Forty-five of the participants had high levels, 23 had medium levels, while the remaining 32 had low levels (Lipson et al., 2018). The correlation and ANOVA, which had a degree of era margin of 0.05, were allowed (Lipson et al., 2018). This finding aligns intending to have clear and comprehensive outcomes.
If the results would be not significant, it means that students are not subjected to more pressure on average. If the study results in significant outcomes, this would mean that there is much that needs to be done to reduce student’s anxiety. The idea that scholarly accomplishment is indispensable to progress is built up in higher instructive conditions (Nelson & Liebel, 2018). Many colleges devote money to tutoring, extra instruction, and other support services to help students succeed.
The study will have to follow the APA ethical guidelines because it involves experimenting with humans. Some of the policies include having consent from the participant, debriefing the participant on the study’s nature, and getting IRB permission (Nelson & Liebel, 2018). Ethical guidelines should comply with proficient, institutional, and government rules. They habitually administer understudies whom they likewise instruct to give some examples of obligations.
The study also had some limitations, making it hard to get the desired outcomes. It was not easy to detect the population-level connections, but not causality. This case hardened the aspect of confounding and getting the relevant random assignment needed for the study had to access (Nelson & Liebel, 2018). For the right individuals for the investigation to be identified, the sampling was not easy.
This study would be essential as it will create a platform for future studies. The result that was gotten shows that many college students are undergoing the problem of anxiety and depression without knowing that it is happening. Educators will have an awareness on what aspects of academics they need to modify to ensure their students are not experiencing mental health challenges. Hence, it makes it possible for future researchers to conduct studies to provide possible solutions.
Chang, J., Yuan, Y., & Wang, D. (2020). Mental health status and its influencing factors among college students during the epidemic of COVID-19. Journal of Southern Medical University , 40(2), 171-176.
Ghrouz, A. K., Noohu, M. M., Manzar, D., Warren Spence, D., BaHammam, A. S., & Pandi-Perumal, S. R. (2019). Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing Journal , 23(2), 627-634.
Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research , 107, 1-10.
Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2019). Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: A systematic review. Journal of Medical Internet Research , 21(7), e12869.
Li, Y., Zhao, J., Ma, Z., McReynolds, L. S., Lin, D., Chen, Z.,… & Liu, X. (2021). Mental health among college students during the COVID-19 pandemic in China: A 2-wave longitudinal survey. Journal of Affective Disorders , 281, 597-604.
Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities among college students of color. Journal of Adolescent Health , 63(3), 348-356.
Nelson, J. M., & Liebel, S. W. (2018). Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant, sex, and subtype differences. Journal of American College Health , 66(2), 123-132.
Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Journal of Affective Disorders , 67(5), 295-301.
IvyPanda. (2023, April 10). Anxiety and Depression Among College Students. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/
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1. IvyPanda . "Anxiety and Depression Among College Students." April 10, 2023. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/.
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IvyPanda . "Anxiety and Depression Among College Students." April 10, 2023. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/.
Depression is undeniably one of the most prevalent mental health conditions globally, affecting approximately 5% of adults worldwide. It often manifests as intense feelings of hopelessness, sadness, and a loss of interest in previously enjoyable activities. Many also experience physical symptoms like fatigue, sleep disturbances, and appetite changes. Recognizing and addressing this mental disorder is extremely important to save lives and treat the condition.
In this article, we’ll discuss how to write an essay about depression and introduce depression essay topics and research titles for students that may be inspirational.
🔝 top 12 research titles about depression.
Struggling to find inspiration for your essay? Look no further! We’ve put together some valuable essay prompts on depression just for you!
Sharing your own experience with depression in a paper can be a good idea. Others may feel more motivated to overcome their situation after reading your story. You can also share valuable advice by discussing things or methods that have personally helped you deal with the condition.
For example, in your essay about depression, you can:
Sadness is a common human emotion, but depression encompasses more than just sadness. As reported by the National Institute of Mental Health, around 21 million adults in the United States, roughly 8.4% of the total adult population , faced at least one significant episode of depression in 2020. When crafting your essay about overcoming depression, consider exploring the following aspects:
The birth of a child often evokes a spectrum of powerful emotions, spanning from exhilaration and happiness to apprehension and unease. It can also trigger the onset of depression. Following childbirth, many new mothers experience postpartum “baby blues,” marked by shifts in mood, bouts of tears, anxiety, and sleep disturbances. To shed light on the subject of postpartum depression, explore the following questions:
Teenage depression is a mental health condition characterized by sadness and diminishing interest in daily activities. It can significantly impact a teenager’s thoughts, emotions, and behavior, often requiring long-term treatment and support.
By discussing the primary symptoms of teenage depression in your paper, you can raise awareness of the issue and encourage those in need to seek assistance. You can pay attention to the following aspects:
Depression essay topics: cause & effect.
Informative speech topics about depression.
We’ve prepared some tips and examples to help you structure your essay and communicate your ideas.
An introduction is the first paragraph of an essay. It plays a crucial role in engaging the reader, offering the context, and presenting the central theme.
A good introduction typically consists of 3 components:
Hook : Depression is a widespread mental illness affecting millions worldwide.
Background information : Depression affects your emotions, thoughts, and behavior. If you suffer from depression, engaging in everyday tasks might become arduous, and life may appear devoid of purpose or joy.
A good thesis statement serves as an essay’s road map. It expresses the author’s point of view on the issue in 1 or 2 sentences and presents the main argument.
Thesis statement : The stigma surrounding depression and other mental health conditions can discourage people from seeking help, only worsening their symptoms.
The main body of the essay is where you present your arguments. An essay paragraph includes the following:
Topic sentence : Depression is a complex disorder that requires a personalized treatment approach, comprising both medication and therapy.
Evidence : Medication can be prescribed by a healthcare provider or a psychiatrist to relieve the symptoms. Additionally, practical strategies for managing depression encompass building a support system, setting achievable goals, and practicing self-care.
The conclusion is the last part of your essay. It helps you leave a favorable impression on the reader.
The perfect conclusion includes 3 elements:
Rephrased thesis: In conclusion, overcoming depression is challenging because it involves a complex interplay of biological, psychological, and environmental factors that affect an individual’s mental well-being.
Summary: Untreated depression heightens the risk of engaging in harmful behaviors such as substance abuse and can also result in negative thought patterns, diminished self-esteem, and distorted perceptions of reality.
We hope you’ve found our article helpful and learned some new information. If so, feel free to share it with your friends. You can also try our free online topic generator !
414 proposal essay topics for projects, research, & proposal arguments.
Recent research has drawn a link between anxiety, depression and an increased risk of deep vein thrombosis.
Having anxiety or depression may increase the risk of potentially life-threatening blood clots, known as deep vein thrombosis (DVT).
With DVT, a blood clot forms in a deep vein, usually in the legs. DVT can cause damage by limiting blood flow to the site of the clot and increasing pressure in veins. A larger danger arises if some or all of that clot breaks loose and then travels to the lungs , where it can block blood flow, causing shortness of breath, chest pain and even death.
Within the last decade, scientists have uncovered links between people's mental health and their risk of these blood clots. However, conflicting study results and complicating factors — such as some study subjects' medication use and histories of high blood pressure — have made it difficult to determine exactly how the two are connected.
Now, a study published July 4 in the American Journal of Hematology has examined not only how much anxiety or depression can raise a person's risk of DVT but also why.
Related: Rare clotting effect of early COVID shots finally explained
"My research comes from my patients," Dr. Rachel Rosovsky , lead study author and director of thrombosis research in the Division of Hematology at Massachusetts General Hospital, told Live Science. "When I realized the association between long-term anxiety and depression and blood clots, I started to think about whether those conditions could affect a patient's risk of developing a clot."
To investigate the link, the researchers looked retrospectively at data from almost 119,000 people. The data included measurements of stress-related brain activity obtained using positron emission tomography (PET). PET scans reveal the activity levels and energy use of different parts of the brain.
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The researchers compared the activity of the amygdala — a brain region that processes and responds to potential threats — to that of the ventromedial prefrontal cortex, which helps regulate the amygdala and thus control emotional responses. In that way, the researchers got a snapshot of stress-related neural activity, or SNA.
The data also included measures of high-sensitivity C-reactive protein, a marker of inflammation , and heart rate variability, a measure of adaptability . The higher your heart rate variability, the better your body can cope with stressful situations.
Of the overall group, about 106,450 had a diagnosis of anxiety, while 108,790 had depression; there's overlap in these groups as many participants had both conditions.
Over an average follow-up time of 3.6 years, about 1,780 study participants experienced DVT. Those with a history of anxiety or depression were 53% and 48% more likely to experience DVT, respectively, compared with those with no history of either condition. Similar trends were seen among people with both conditions.
Related: 6 distinct forms of depression identified by AI in brain study
Furthermore, of 1,520 people who got PET scans, those with anxiety or depression showed higher SNA than those without either condition. People with higher-than-normal levels of this activity were 30% more likely to experience DVT than those with normal levels.
"We first showed that anxiety and depression were significantly associated with increased SNA," Rosovsky said. Then, the team found that SNA was associated with increased leukopoietic activity , meaning the creation of white blood cells — a driver of inflammation.
This had previously been shown to "promote clotting through many different mechanisms," she said. And now, the team has connected the dots from anxiety and depression to SNA and on to DVT risk.
Three potential mechanisms connect anxiety and depression to DVT: higher SNA, higher inflammation and reduced heart rate variability. It appears that the more stress a person experiences, the higher their risk of DVT, the researchers concluded.
This "intriguing study" sheds light on how SNA influences the production of blood in the body, said Kamran Mirza , a professor of hematopathology at the University of Michigan who was not involved in the study. It reveals a "potential connection between mental health and increased clotting risk that warrants further investigation," Mirza told Live Science.
Notably, the researchers were limited to data that had already been collected. Prospective studies that follow people over time would enable scientists to track changes in stress and inflammation and see how they relate to DVT. The team plans to examine how treating anxiety or depression might affect DVT rates, and they also want to see if somehow reducing SNA could reduce risk.
— An astronaut got a blood clot in space. Here's how doctors on Earth fixed it .
— Can chronic stress cause or worsen cancer? Here's what the evidence shows .
— How anxiety affects the body: 5 physical symptoms, according to science
"If you have depression or anxiety, be aware that those are potential risk factors for blood clots," Rosovsky said. "But also think about whether you have other risk factors and what you can do about those to reduce your risk."
This article is for informational purposes only and is not meant to offer medical advice.
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Refugees, particularly unaccompanied refugee minors (URM), often report poor mental health. Psychological Flexibility (PF), derived from Acceptance and Commitment Therapy (ACT), appears to positively impact mental health in various populations, including adolescents and refugees. This study aimed to examine the structure of the PF model and the connections among its core processes, as well as the structure and connections between mental health constructs (i.e., post-traumatic stress, depression, anxiety, stress, quality of life) and PF in URM. 100 URM aged 13–18 years living in shelters in the Republic of Cyprus completed four self-reports, assessing depression, anxiety, and stress (DASS-21), PF (Psy-Flex), PTSD (CRIES-13), and HRQL (KIDSCREEN-10). Network Analysis was used to examine the structure and connections of the constructs. Most core PF processes showed positive connections amongst each other, with the strongest edge between committed action and values. Together with self as context, these core processes exhibited the highest expected influence. The strongest positive connections in the mental health network were found among stress, anxiety, and depression. Stress had the highest expected influence, whereas PF had the lowest. A post hoc Johnson-Neyman analysis suggested a buffering effect of PF on the impact of PTSD on anxiety and stress. Proposed areas of focus for clinicians working with URM include incorporating strategies that address stress symptoms and facilitate individuals in pursuing value-based behavior. It is equally important to encourage critical reflection on values and the conceptualized self in the context of culture.
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Anxiety disorders are normally brained reactions to stress as they alert a person of impending danger. Most people feel sad and low due to disappointments. Feelings normally overwhelm a person leading to depression, especially during sad moments such as losing a loved one or divorce. When people are depressed, they engage in reckless behaviors ...
2 pages / 702 words. Introduction Depression is an insidious condition that affects millions of people worldwide. It is a complex mental health disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities. This narrative essay aims to delve into the personal...
1. Introduction. The World Health Organization [] estimates that 264 million people worldwide were suffering from an anxiety disorder and 322 million from a depressive disorder in 2015, corresponding to prevalence rates of 3.6% and 4.4%.While their prevalence varies slightly by age and gender [], they are among the most common mental disorders in the general population [2,3,4,5,6].
Across all psychiatric disorders, comorbidity is the rule (), which is definitely the case for anxiety and depressive disorders, as well as their symptoms.With respect to major depression, a worldwide survey reported that 45.7% of individuals with lifetime major depressive disorder had a lifetime history of one or more anxiety disorder ().These disorders also commonly coexist during the same ...
Depression is a disorder characterized by prolonged periods of sadness and loss of interest in life. The symptoms include irritability, insomnia, anxiety, and trouble concentrating. This disorder can produce physical problems, self-esteem issues, and general stress in a person's life. Difficult life events and trauma are typical causes of ...
called "I BEAT ANXIETY DEPRESSION, now what?". It is a very engaged group of warriors who are ready to heal and share their journey and their story for ongoing healing and support! Evidence-based Tips & Strategies from our Member Experts. Unseen Trauma: Recognizing and Understanding Childbirth-Related PTSD.
Depression And Anxiety - Free Essay Examples and Topic Ideas. Depression is a serious mental illness that is characterized by a persistent feeling of sadness or hopelessness, loss of interest in activities, changes in appetite and sleeping patterns, fatigue, difficulty concentrating, and sometimes thoughts of self-harm or suicide.
Anxiety is the emotion that causes severe physical changes, can negatively affect social contacts, and even lead to depression. Here we've gathered top research questions about anxiety disorder as a mental health issue, as well as anxiety essay examples.
Social anxiety is also known as social phobia. Social anxiety disorder is the most common anxiety disorder, affecting over 10 million Americans. This disorder can develop as early in childhood, mid-teens, or even in adulthood. Social anxiety can be inherit usually through family history.
250 Words Essay on Depression And Anxiety What is Depression and Anxiety? Depression and anxiety are types of mental health problems. Depression makes people feel sad, tired, and lose interest in things they once loved. Anxiety often makes people worry too much about different things. It's like a fear or dread that doesn't go away.
Conclusion. A major aim of this course was to shed some light on the aetiology of depression and anxiety. At the end of it you should have some idea of the complexity of this enterprise. We have focused on one of the best-studied and hence best-understood contributors to psychopathology - stress. This has biological, social and psychological ...
Anxiety is the feeling and behavior of worryness and fear strong enough to interfere with a person's daily life. Depression is a disorder that is both very serious and very common. It negatively affects individuals, causing them to feel extreme sadness and loss of interest in doing something once before enjoyed.
3. In one phrase, state the purpose of your essay. Consider what you want to happen when other people read your article. 4. Examine your notes and construct a list of all the key things you wish to emphasize. Make use of brainstorming strategies and jot down any ideas that come to mind. 5. Review and revise the arguments and write a thesis ...
Treatment for anxiety and depression can include talking to a therapist or taking medicine. It can take time to feel better, but many people do. Remember, it's okay to ask for help. 250 Words Essay on Anxiety And Depression Understanding Anxiety and Depression. Anxiety and depression are mental health issues that affect many people.
Depression and Anxiety welcomes original research and review articles covering neurobiology (genetics and neuroimaging), epidemiology, experimental psychopathology, and treatment (psychotherapeutic and pharmacologic) aspects of mood and anxiety disorders and related phenomena in humans. Articles Most Recent; Research Article ...
The Loneliness and Anxiety: In some ways I consider this step one of when my depression spikes because it always seems to come first. But I don't consider it step one in levels of horribleness. Like I said above I really think that both ways my depression hits me are pretty awful and I couldn't say which is worse.
The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018).
30. Our Experts. can deliver a custom essay. for a mere 11.00 9.35/page --- qualified. specialists online Learn more. Depression is undeniably one of the most prevalent mental health conditions globally, affecting approximately 5% of adults worldwide. It often manifests as intense feelings of hopelessness, sadness, and a loss of interest in ...
Conclusion depression. Depression is one of the most common conditions in primary care, but is often unrecognized, undiagnosed, and untreated. Depression has a high rate of morbidity and mortality when left untreated. Most patients suffering from depression do not complain of feeling depressed, but rather anhedonia or vague unexplained symptoms.
Depression In College Essay; Depression In College Essay. 2266 Words 10 Pages ... "1 out of every 4 college students suffers from some form of mental illness," (Kerr) whether it be depression, anxiety, eating disorder or any of the like our kids are suffering and they need our help. Mental illness on the college campus is becoming an epidemic.
Bipolar Disorder used to be known as "manic depression", because the person experiences depression, normal mood and mania, which is basically the opposite of depression. Symptoms for Bipolar Disorder include feeling great, having a lot of energy, having racing thoughts, little need for sleep, taking fast, having difficulty focusing on tasks ...
Being socially engaged to people may reduce stress, anxiety, and depression, improve self-worth, bring solace and joy, avoid loneliness, and even lengthen one's life. On the other hand, having few close friends puts your mental and emotional wellbeing at danger.
Having anxiety or depression may increase the risk of potentially life-threatening blood clots, known as deep vein thrombosis (DVT). With DVT, a blood clot forms in a deep vein, usually in the ...
The strongest positive connections in the mental health network were found among stress, anxiety, and depression. Stress had the highest expected influence, whereas PF had the lowest. A post hoc Johnson-Neyman analysis suggested a buffering effect of PF on the impact of PTSD on anxiety and stress.