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September 17, 2026Psychosomatic Medicine

Depressive symptoms linked to up to ~124% higher odds of advanced CKM syndrome.

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Why the study?

Are depressive symptoms associated with advanced cardiovascular-kidney-metabolic syndrome in U.S. adults?

Population

30,244 U.S. adults from the National Health and Nutrition Examination Survey (NHANES)

Comparison

Depressive symptoms vs No depressive symptoms

Design

Cross-sectional

Key result

Depressive symptoms were associated with higher odds of advanced cardiovascular-kidney-metabolic syndrome in women (OR 2.24; 95% CI 1.74-2.88) and men (OR 1.75; 95% CI 1.34-2.28).

Authors

RFRaphael FraserTDTatiana M. DavidsonRWRebekah J. Walker

Discussion

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Overview

May inform integrated mental health screening in CKM care; leaves open causality and intervention effects pending longitudinal data.

Key Points

  • To evaluate the association between depressive symptoms and advanced cardiovascular–kidney–metabolic syndrome among U.S. adults and assess whether demographic, socioeconomic, or behavioral factors moderate this relationship.
  • Analyzed cross-sectional National Health and Nutrition Examination Survey data from 30,244 U.S. adults.
  • Assessed depressive symptoms using the Patient Health Questionnaire-9 and classified cardiovascular–kidney–metabolic syndrome stages using American Heart Association criteria (stages 0–2 nonadvanced vs stages 3–4 advanced).
  • Applied survey-weighted logistic regression to calculate odds ratios and evaluated interaction terms for age, sex, race and ethnicity, poverty-income ratio, education, and smoking status.
  • Advanced cardiovascular–kidney–metabolic syndrome was present in 16% of adults, while 8% had depressive symptoms.
  • Depressive symptoms were associated with increased odds of advanced syndrome in fully adjusted models for both women (OR, 2.24; 95% CI, 1.74–2.88) and men (OR, 1.75; 95% CI, 1.34–2.28).
  • Significant effect modification demonstrated a stronger association in women (interaction OR, 1.58; 95% CI, 1.12–2.23; P = 0.010) and a weaker association at age ≥65 versus 30–49 years (interaction OR, 0.42; 95% CI, 0.27–0.67; P < 0.001).

Study Design

Type

Cross-Sectional (n=30,244)

Structured PICO

Are depressive symptoms associated with advanced cardiovascular-kidney-metabolic syndrome in U.S. adults?

P
Population
30,244 U.S. adults from the National Health and Nutrition Examination Survey evaluated for the association between depressive symptoms and advanced cardiovascular-kidney-metabolic syndrome.
E
Exposure
Depressive symptoms (assessed using the Patient Health Questionnaire-9)
C
Comparator
No depressive symptoms
O
Outcome
Advanced cardiovascular-kidney-metabolic (CKM) syndrome (defined as AHA stages 3 to 4)composite

Main Result

Odds Ratio: 2.24 (95% CI 1.74–2.88)

Depressive symptoms are significantly associated with advanced cardiovascular-kidney-metabolic syndrome in U.S. adults, with a stronger association observed in women.

Cite This Study

Fraser et al. (2026) conducted a cross-sectional in advanced cardiovascular-kidney-metabolic (CKM) syndrome (n=30,244). Depressive symptoms vs. No depressive symptoms was evaluated on advanced CKM (stages 3 to 4) (OR 2.24, 95% CI 1.74-2.88). Depressive symptoms were associated with higher odds of advanced cardiovascular-kidney-metabolic syndrome in women (OR 2.24; 95% CI 1.74-2.88) and men (OR 1.75; 95% CI 1.34-2.28).

synapsesocial.com/papers/6aabb8375f706d05830e7cd1https://doi.org/10.1097/psy.0000000000001527
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Association Between Depression and Advanced Stages of Cardiovascular–Kidney–Metabolic Syndrome2026
  2. 2Association between cardiovascular-kidney-metabolic syndromeand depressive symptoms in middle-aged and older Chineseadults: a cross-sectional and longitudinal analysis2026
  3. 3Sex-Specific Associations Between Depression and Cardiovascular-Kidney-Metabolic Syndrome Progression: A National Cohort Study2026 · 4 citations
  4. 4Association of cardiovascular-kidney-metabolic syndrome with depression and all-cause mortality: a population-based observational study2025 · 6 citations
  5. 5Joint Association of Functional Impairment and Depression with Advanced Cardiovascular–Kidney–Metabolic Syndrome: A Cross-Sectional and Cohort Study Using Two Large Datasets2026