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The Association Between Symptoms of Anxiety, Depression, and Cardiovascular Risk Factors

Results From an Italian Cross-Sectional Study

Rioli, Giulia, MD*†; Tassi, Silvia, MD*; Mattei, Giorgio, MD*‡§; Ferrari, Silvia, MD, PhD*∥; Galeazzi, Gian Maria, MD, PhD*∥; Mancini, Stefano, MD, PhD; Alboni, Silvia, MD, PhD#; Roncucci, Luca, MD, PhD

The Journal of Nervous and Mental Disease: May 2019 - Volume 207 - Issue 5 - p 340–347
doi: 10.1097/NMD.0000000000000969
Original Articles

Cardiovascular diseases, anxiety, and depression are among the most frequent clinical conditions in the Western world, often in comorbidity. Evidence regarding a shared pathophysiology suggests a mediating role by chronic systemic inflammation. The aims of this study were to measure the association between anxiety and depressive symptoms, cardiovascular risk factors, and inflammatory markers. Outpatients aged 40 years or more undergoing colonoscopy after positive fecal occult blood test were enrolled; the following data were collected: body mass index, blood pressure, blood glucose, lipid profile, C-reactive protein (CRP) level, carotid thickness, Hospital Anxiety and Depression Scale, Temperament and Character Inventory, INTERdisciplinary MEDicine Self-Assessment, and 36-Item Short-Form Health Survey scores. Fifty-four patients were enrolled; 30.2% had anxiety symptoms, 18.9% depressive symptoms, and 9.4% concomitant anxiety-depressive symptoms. Anxiety symptoms were associated with low high-density lipoprotein levels. Depressive symptoms were associated with CRP levels, providing supporting evidence for the role of inflammation in the pathophysiology of depression.

*Department of Biomedical, Metabolic and Neural Sciences, and

PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia;

PhD Program in Labour, Development and Innovation, Department of Economics, University of Modena and Reggio Emilia and Marco Biagi Foundation;

§Association for Research in Psychiatry; and

Center for Neuroscience and Neurotechnology,

Department of Medical and Surgical Sciences, and

#Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Send reprint requests to Giulia Rioli, MD, Clinica Psichiatrica, Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71-41124 Modena, Italy. E-mail:

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