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. 2024 Aug;54(11):2866-2875.
doi: 10.1017/S0033291724000916. Epub 2024 Apr 15.

Midlife diseases of despair and cardiometabolic risk: testing shared origins in adolescent psychopathology

Kallisse R Dent  1 , Grace M Brennan  2   3 , Lara Khalifeh  1 , Leah S Richmond-Rakerd  1
Affiliations

Midlife diseases of despair and cardiometabolic risk: testing shared origins in adolescent psychopathology

Kallisse R Dent et al. Psychol Med. 2024 Aug.

Erratum in

Abstract

Background: Rising midlife mortality in the United States is largely attributable to 'deaths of despair' (deaths from suicide, drug poisonings, and alcohol-related diseases) and deaths from cardiometabolic conditions. Although despair- and cardiometabolic-related mortality are increasing concurrently, it is unclear whether they share common developmental origins. We tested adolescent psychopathology as a potential common origin of midlife diseases of despair and cardiometabolic risk.

Methods: Participants (N = 4578) were from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative cohort followed from adolescence to early midlife. Adolescent psychopathology included depression, anxiety, eating disorders, PTSD, conduct disorder, and ADHD at ages 11-18. Diseases of despair (suicidality, substance misuse, pain, and sleep problems) and cardiometabolic risk (hypertension, hyperlipidemia, high-risk waist circumference, diabetes, and cardiovascular conditions) were multi-modally measured at ages 33-43.

Results: At midlife, adolescents who experienced psychopathology exhibited more indicators of despair-related diseases and cardiometabolic risk (IRRs = 1.67 [1.46-1.87] and 1.13 [1.04-1.21], respectively), even after accounting for demographics, adolescent SES, and adolescent cognitive ability. Associations were evident for internalizing and externalizing conditions, and in a dose-response fashion. In mediation analyses, low education explained little of these associations, but early-adult substance use explained 21.5% of psychopathology's association with despair-related diseases. Midlife despair-related diseases and cardiometabolic risk co-occurred within individuals (IRR = 1.12 [1.08-1.16]). Adolescent psychopathology accounted for 8.3% of this co-occurrence, and 16.7% together with adolescent SES and cognitive ability.

Conclusions: Adolescent psychopathology precedes both diseases of despair and cardiometabolic risk. Prevention and treatment of psychopathology may mitigate multiple causes of poor midlife health, reducing premature mortality.

Keywords: adolesecent psychopathology; cardiometabolic risk; diseases of despair; midlife morbidity.

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Conflict of interest statement

Disclosures: The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.. Measures and corresponding waves from the National Longitudinal Study of Adolescent to Adult Health1
1 Only waves from which data were drawn are shown. 2 Education information from Wave IV was only used if Wave V information was unavailable. 3 Retrospective reports of adolescent psychopathology from Wave V were only used if Wave IV information was unavailable.
Figure 2.
Figure 2.
Incidence rate ratios and 95% confidence intervals for associations of adolescent psychopathology with midlife diseases of despair and cardiometabolic risk
See this image and copyright information in PMC

References

    1. Abdul-Rahman A-K, Card TR, Grainge MJ, & Fleming KM (2018). All-Cause and Cause-Specific Mortality Rates of Patients Treated for Alcohol Use Disorders: A Meta-Analysis. Substance Abuse, 39(4), 509–517. 10.1080/08897077.2018.1475318 - DOI - PubMed
    1. Ames ME, Leadbeater BJ, & MacDonald SWS (2018). Health behavior changes in adolescence and young adulthood: Implications for cardiometabolic risk. Health Psychology, 37(2), 103–113. 10.1037/hea0000560 - DOI - PubMed
    1. Beccuti G, & Pannain S (2011). Sleep and obesity: Current Opinion in Clinical Nutrition and Metabolic Care, 14(4), 402–412. 10.1097/MCO.0b013e3283479109 - DOI - PMC - PubMed
    1. Beseran E, Pericàs JM, Cash-Gibson L, Ventura-Cots M, Porter KMP, & Benach J (2022). Deaths of Despair: A Scoping Review on the Social Determinants of Drug Overdose, Alcohol-Related Liver Disease and Suicide. International Journal of Environmental Research and Public Health, 19(19), 12395. 10.3390/ijerph191912395 - DOI - PMC - PubMed
    1. Blodgett JM, Lachance CC, Stubbs B, Co M, Wu Y-T, Prina M, … Cosco TD (2021). A systematic review of the latent structure of the Center for Epidemiologic Studies Depression Scale (CES-D) amongst adolescents. BMC Psychiatry, 21(1), 197. 10.1186/s12888-021-03206-1 - DOI - PMC - PubMed