JMIR Publications

ABSTRACT

Background:

Comorbidity of psychiatric disorders such as depression, anxiety are very common among children and adolescents. Few studies have examined how comorbidity of anxiety and depression are associated with health risk behaviors (HRBs) in adolescents, which could inform preventative approaches for mental health.

Objective:

We evaluated the association between HRBs and comorbidity of anxiety and depression in a large adolescent cohort.

Methods:

We used data of 22 868 adolescents from the National Youth Cohort (China). Anxiety and depression symptoms were assessed using Patient Health Questionnaire 9-item Scale and Generalized Anxiety Disorder 7-item Scale, respectively. Comorbidity was determined by coexistence of anxiety and depression. HRBs including poor diet, smoking, physical inactivity and poor sleep, and the above HRBs scores were added to obtain the total HRBs score (HRBs risk index). Binary logistic regression estimated odds ratios before and after adjusting for potential confounders.

Results:

HRBs were associated with comorbidity of anxiety and depression in Chinese adolescents. For single HRB, adolescents with high risk were more likely have comorbidity of anxiety and depression after adjusting for confounders. Moreover, in both unadjusted (OR: 3.09, 95%CI: 2.72-3.52) and adjusted (OR: 2.33, 95%CI: 2.03-2.68) models, clustered HRBs were positively associated with anxiety-depression comorbidity (may exist gender differences), and the association strength was stronger than any single HRB.

Conclusions:

We provide evidence that HRBs are related to comorbidity of anxiety and depression. Interventions that decrease HRBs may support mental health development in adolescence, with the potential to improve health and well-being through to adulthood.