Association between Early-Onset Metabolic Diseases and Adverse Mental Health Conditions: A Nationwide Cross-Sectional Study

Purpose: Though metabolic diseases increasingly affect younger populations, their mental health implications remain poorly understood.We examined associations between age at metabolic disease diagnosis and mental health conditions, comparing early-onset (age <40 years) and late-onset (age ≥40 years) cases. Materials and Methods:We analyzed the 2014-2023 Korea National Health and Nutrition Examination Survey.Participants reported physician-diagnosed hypertension, diabetes, or dyslipidemia, with age at diagnosis.Mental health conditions included depression, perceived stress, and suicidality.Depression was assessed using the Patient Health Questionnaire-9, perceived stress through self-reported daily experiences, and suicidality as the presence of suicidal ideation, planning, or attempts within the past year.Associations were examined using multiple logistic regression with Bonferroni correction.Results: Early-onset hypertension [odds ratio (OR)=2.67;95% confidence interval (CI): 1.91-3.74]and dyslipidemia (OR=2.55;95% CI: 1.71-3.79)showed higher odds of depression compared to undiagnosed and late-onset cases (p-diff.<0.001 and p-diff.=0.001, respectively).Early-onset hypertension (OR=1.41;95% CI: 1.21-1.66)and dyslipidemia (OR=1.90;95% CI: 1.59-2.26)showed higher odds of perceived stress compared to undiagnosed and late-onset cases (both p-diff.<0.001).Early-onset diabetes (OR=2.76;95% CI: 1.79-4.25)showed higher odds of suicidality compared to undiagnosed and late-onset cases (p-diff.<0.001).Conclusion: Early-onset metabolic diseases showed stronger associations with adverse mental health conditions than late-onset cases, with patterns suggesting these associations were not primarily explained by disease duration.While the cross-sectional design limits causal inference, mental health screening in early-onset metabolic disease care could be considered.