Relationships between anxiety, depression self-ratings and CHD risk factors among obese, normal and lean individuals

Abstract

Psychosomatic interactions leading to the development of Coronary Heart Disease (CHD) have yet to be clarified. This study explores further whether and how an important CHD risk factor, relative weight, affects the relationships between psychological and bioclinical parameters. A principal factorial components solution (linear procedure) and an extension of the median test (non-linear procedure) were run on the scores of self-reported anxiety (IPAT Anxiety Scale) and depression (Zung Self-rating Scale), the indices of anxiety expression style, and the bioclinical measures (systolic and diastolic blood pressure, fasting blood glucose, urea and lip concentrations). The statistical procedures were carried out separately in the six subgroups which subdivide 1,694 male volunteers to a CHD detection examination, according to age (under- and over-45 yr) and relative weight (obese, normal and lean subjects). Results indicate that the relationship between psychological and bioclinical measures are specific to the subgroup considered: they are recurrent in obese and lean individuals, and more frequent in older than in younger subjects. The composition of the first factorial component is psycho-bioclinical in the under-45 obese subgroup; the second factorial component is biopsychological in the obese and lean, under- as well as over-45-yr old, subgroups. The expression style indices and the lipid concentrations are associated when the statistical method does not presuppose linearity. Present theories on psychological and bioclinical determinants of relative weight are reported, since the experimental data upon which these theories are based parallel interestingly the results of our correlational study. Indeed, both approaches suggest that cognitive factors, operationally defined by response tendencies and anxiety expression style, are different in obese and nonobese humans, and that these differences determine psycho-bioclinical relationships which are specific to these relative weight groups. Could these mechanisms of action be specified, an important step would be made in the understanding of the CHD etiology.