A strong sense of coherence associated with reduced risk of anxiety disorder among women in disadvantaged circumstances: British population study.
Wainwright, Nicholas WJ
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Remes, O., Wainwright, N. W., Surtees, P., Lafortune, L., Khaw, K., & Brayne, C. (2018). A strong sense of coherence associated with reduced risk of anxiety disorder among women in disadvantaged circumstances: British population study.. BMJ open, 8 (4), e018501. https://doi.org/10.1136/bmjopen-2017-018501
OBJECTIVE Many patients receiving medical treatment for anxiety relapse or do not improve. Research has therefore been turning to coping mechanisms as a way to decrease anxiety rates. Previously, we showed that living in a deprived area significantly increases the risk of anxiety in women, but not in men. The objective of this study is to assess whether sense of coherence (coping mechanism) buffers the influence of area deprivation on women’s risk of generalized anxiety disorder using data from the European Prospective Investigation of Cancer-Norfolk. DESIGN Large, population study. SETTING UK population-based cohort. PARTICIPANTS 30,445 people over the age of 40 were recruited through general practice registers in England. Of these, 20,919 completed a structured health and lifestyle questionnaire used to assess generalized anxiety disorder and sense of coherence. Area deprivation was measured using 1991 Census data, and sense of coherence and anxiety were examined in 1996-2000. 10,183 women had complete data on all covariates. MAIN OUTCOME MEASURE Past-year generalized anxiety disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. RESULTS In this study, 2.6% (260/10,183) of women had generalized anxiety disorder. In those with a strong sense of coherence, area deprivation was not significantly associated with anxiety (OR=1.29, 95% CI: 0.77, 2.17). However, among women with a weak sense of coherence, those living in deprived areas were almost twice as likely to have generalized anxiety disorder compared to those living in more affluent areas (OR=1.99, 95% CI: 1.37, 2.91). CONCLUSION The absolute number of women living in deprived conditions is large worldwide, and significant numbers are affected by generalized anxiety disorder. Sense of coherence moderates the association between area deprivation and anxiety in women; therefore, interventions targeting coping mechanisms may need to be considered for people with anxiety.
Humans, Risk Factors, Prospective Studies, Anxiety Disorders, Depressive Disorder, Major, Aged, Middle Aged, Vulnerable Populations, England, Female, Sense of Coherence
Department of Health (via National Institute for Health Research (NIHR)) (unknown)
MEDICAL RESEARCH COUNCIL (MR/N003284/1)
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External DOI: https://doi.org/10.1136/bmjopen-2017-018501
This record's URL: https://www.repository.cam.ac.uk/handle/1810/275785
Attribution 4.0 International
Licence URL: http://creativecommons.org/licenses/by/4.0/