Association between anxious-depressive symptoms and metabolic syndrome and its single components: an Italian cross-sectional study among primary care outpatients

BACKGROUND: The association between anxious-depressive disorders and Metabolic Syndrome (MetS) has been seldom addressed in literature, despite being common in clinical practice, and with mixed results. Aim of this study was to measure prevalence and association of symptoms of anxiety and/or depression with MetS and its single components among primary care patients.METHODS: Cross-sectional study. The Hospital Anxiety and Depression Scale (HADS) was used to measure symptoms of anxiety and/or depression.RESULTS: Among 210 primary care outpatients (60% women), 84 (40%) had symptoms of anxiety, 30 (14.29%) had depressive symptoms and 26 (12.38%) had anxious-depressive symptoms; 66 patients (31.43% of the total sample) had MetS according to the Adult Treatment Panel III (ATPIII) definition, and 69 (37.62%) according to International Diabetes Federation (IDF) criteria. Anxious (P<0.01), depressive (P<0.01) and comorbid anxious-depressive (P<0.01) symptoms were significantly prevalent in female vs. male patients. At the multivariate logistic regression analysis, symptoms of anxiety were inversely associated to employment status (OR=0.28, P=0.04), and positively associated to waist circumference (ATPIII criteria) (OR=2.07, P=0.03); both depressive (OR=0.17, P<0.01) and anxious-depressive symptoms (OR=0.20, P<0.01) were inversely associated to educational level.CONCLUSIONS: At the regression analysis, a positive association was found between waist circumference, a key component of MetS, and anxiety symptoms, suggesting the need to clinically manage these two dimensions in a coordinated way. Further research is needed to better understand the causative pathways of this correlation.