Chronic Anxiety and Depression Significantly Increase the Risk of Early Death




 

A large new study suggests that chronic anxiety and depression are associated with a higher risk of premature death than was previously appreciated.


 

 

CHRONIC ANXIETY AND DEPRESSION SIGNIFICANTLY INCREASE THE RISK OF EARLY DEATH

As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, most previous research studies have suggested only rather weak links between chronic stress and cancer risk, although there is some data linking chronic depression with breast cancer risk.  However, in view of the increasing number of people around the world who are currently experiencing chronic anxiety and depression during these economically and geopolitically troubled times, the findings of a new public health study that psychological distress significantly increases the risk of premature death from serious illnesses, including cancer, is concerning.  This new study appears in the current issue of the British Medical Journal.

Altogether, 68,222 adults in Great Britain were followed for an average of more than 8 years within the prospectively conducted Health Survey for England study.  All of these study participants were clinically free of serious physical illness when they first joined this very large public health study.  All of the participants in this study were assessed for psychological stress using a validated assessment questionnaire, which was administered in their homes by research staff.  Subsequently, the incidence of serious physical illnesses during the course of this study was then correlated with the degree of measured psychological distress.  The rather dramatic findings of this large prospective public health study illustrate the magnitude of the impact of chronic, severe stress on our bodies, including the risk of premature death due to stress-associated physical illnesses.

After adjusting for preexisting serious physical illnesses, lifestyle-associated risk factors for serious illnesses, and socioeconomic factors known to be linked to chronic, serious illnesses, this study still identified a highly significant increase in the risk of premature death associated with the extent of psychological distress among volunteers in this very large study.  When the “psychological distress score” was compared with death rates, having a score of 1 to 3 (compared to a score of “0,” which reflects no evidence of psychological distress) was associated with a 20 percent increase in the risk of premature death.  A psychological stress score of 4 to 6 was associated with a 43 percent increase in the risk of early death, while a distress score of 7 to 12 was associated with a whopping 94 percent increase in the risk of premature death when compared to study volunteers who were without evidence of any significant psychological distress!

Upon further analysis, death due to cardiovascular disease and other non-cancer causes increased significantly, and proportionally, with each increase in the psychological distress score.  Cancer-associated deaths also increased with rising psychological distress scores, although this association was only observed among volunteers with significantly elevated distress scores.  However, for non-cancer causes of death, the risk of premature death was significantly elevated with evenmild increases in psychological distress.

The potential impact of this study’s findings are highly significant, as they not only reveal a “dose-dependent” relationship between stress levels and the risk of premature death from serious physical illnesses, but the sheer magnitude of the impact of high levels of chronic anxiety and depression on the risk of premature death is much higher, potentially, than has been observed in previous and much smaller studies.

Although this study was not designed to identify the biological mechanisms whereby prolonged periods of increased psychological distress lead to early death, numerous prior studies have shown that chronic depression and anxiety can directly activate an inflammatory response in humans which, in turn, is known to increase the risk of cardiovascular disease, infection, and cancer, as well as other chronic, serious illnesses.  It is also well known that chronic anxiety and chronic depression increase the likelihood of unhealthy behaviors that have also been linked to serious, chronic illnesses, including smoking, excess alcohol or other drug intake, unhealthy diets, and lack of exercise, in addition to other unhealthy behaviors.  What is especially unique about this new study (other than its sheer size), however, is that the researchers were able to identify and adjust for preexisting unhealthy behaviors among the study’s volunteers when they analyzed the study’s data, which increases the likelihood that the adverse effects of chronic anxiety and depression on the risk of premature death observed in this research study are actually a direct result of psychological distress rather than unhealthy lifestyle choices.

If you are experiencing high levels of chronic stress, and if you are frequently anxious or depressed, then please seek help from your personal physician or a mental health professional.  If you are thinking of harming yourself, or someone else, then please seek immediate help.  These are very trying times for many people, and the ongoing worldwide challenges that have provoked such high levels of stress do not appear likely to disappear any time soon.  Knowing that so many other people around the world are also feeling worried and chronically stressed can make each of us feel less alone in our distress.  However, sometimes the awareness that others are experiencing similar levels of distress is, by itself, not enough to ease our anxiety or depression.  So, if you are struggling with anxiety or depression, and especially if you are feeling alone and isolated at the same time, then please seek the help and support of others.  In the vast majority of cases, feelings of hopelessness or helplessness will eventually pass when you get help and support during dark times in your life.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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Epidemic of Alcohol Abuse Among Surgeons





A new study indicates that chronic alcohol abuse among surgeons is far more common than among the general population.


 

 

EPIDEMIC OF ALCOHOL ABUSE AMONG SURGEONS

In a previous column (Surgeon Performance and Alcohol), I reviewed a clinical research study that revealed just how significantly alcohol intake degrades surgical skills among surgeons, even well into the day following alcohol intake.  In another recent column, I examined a study that revealed a disturbingly high rate of burnout and depression among American surgeons (Surgeon Burnout and Depression).  This week, I will present a newly published clinical study that, once again, raises serious concerns about the health and wellbeing of many surgeons in the United States.

In a study that appears in the current issue of the Archives of Surgery, more than 7,000 surgeons in the United States agreed to participate in a confidential assessment of alcohol abuse and alcohol dependence among members of the American College of Surgeons.  Validated surveys and tests were administered to these surgeon-volunteers, and the resulting data was analyzed.

Based upon the results of the Alcohol Use Disorders Identification Test, 15 percent of the responding surgeons, overall, were identified as meeting the criteria for either chronic alcohol abuse or alcohol dependence.  Further evaluation of the data collected in this study revealed that 14 percent of the participating male surgeons met the criteria for chronic abuse of alcohol or alcohol dependency, while 26 percent of the corresponding female surgeons met these same worrisome criteria.  Moreover, surgeons who reported having committed a major medical or surgical error within the previous 3 months were 45 percent more likely to abuse alcohol, or to be dependent upon alcohol, when compared to surgeons who did not report any recent errors.  Similarly, surgeons who reported feeling burned out in their professional lives were 25 percent more likely to be problem drinkers when compared to surgeons who did not report professional burnout.  Finally, surgeons who reported symptoms consistent with depression were nearly 50 percent more likely to abuse alcohol than surgeons who did not report feeling depressed.

Interestingly, surgeons were less likely to have alcohol abuse and dependency problems if they were older, male, or had children.  (Approximately 11 percent of adult males in the general population are thought to have chronic alcohol abuse problems, while only about 5 percent of adult females in the general population appear to abuse alcohol on a regular basis.)

The findings of this study, once again, indicate a disturbingly high rate of substance abuse among American surgeons; and this is the first study to show that female surgeons, unlike women in the general population, are twice as likely as their male counterparts to regularly abuse alcohol.  Taken together with previous studies showing very high rates of depression and career burnout among surgeons in the United States, the findings of this latest study are rather worrisome.  (Previous studies have also linked an increased likelihood of medical and surgical errors to surgeons who are depressed, and who abuse alcohol and other drugs.)

I should also note that only 29 percent of the surgeons who were contacted agreed to participate in this confidential study.  Because this participation rate is much lower than what is typically seen in most survey-based research studies, it raises the important question as to whether or not the rate of alcohol abuse and alcohol dependency might actually be considerably higher among surgeons, in general, than what is reflected in this study.  Indeed, most statistics experts believe that a very common reason for nonparticipation in survey-based studies is a reluctance to divulge negative information about oneself.  Moreover, even people who elect to participate in survey-based studies often “fudge” their responses in ways that tend to underestimate their bad habits and other self-perceived shortcomings.  Therefore, it is entirely possible that the incidence of chronic alcohol abuse and alcohol dependency among surgeons may be even higher than what was reported in this study….

 

As I have observed in previous columns, surgeons who abuse alcohol, or other drugs, are more likely to be associated with medical errors and worse patient outcomes.  However, the stigma of reporting oneself as having an alcohol, or other drug, problem is so great in the medical profession that impaired surgeons (as with other physicians) are generally extremely reluctant to admit that they have an alcohol or drug problem.  Most medical boards still require physicians to indicate whether or not they have a history of drug or alcohol abuse on licensure applications, and the medical profession, in general, still seems to be in a state of denial regarding the unusually high incidence of drug and alcohol abuse among physicians when compared to the general public.  It also goes without saying that the potential consequences of being operated upon by an impaired surgeon can be catastrophic to both patients and their loved ones, and, therefore, the still prevailing “head in the sand” approach to identifying, and rehabilitating, impaired physicians would not appear to serve the public interest very well, in my view.

 

While the vast majority of surgeons are passionately devoted to providing the best possible care to their patients, and would therefore not engage in personal behaviors that might potentially endanger their patients, it is becoming increasingly clear that a sizable percentage of surgeons in the United States are seriously impaired by burnout, depression and other mental health illnesses, and by alcohol and drug abuse.  Therefore, a better system of screening out surgical trainees who are predisposed to these serious health problems should be considered, while, at the same time, medical authorities at the state and federal levels should make it easier, and less threatening, for currently impaired physicians and surgeons to reach out for help without fearing that they will be punished or professionally sanctioned as a result.  I, therefore, applaud the American College of Surgeons for sponsoring and publishing this important study as a preliminary step forward in this direction.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a lighthearted perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 








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