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<p>Emerging evidence indicates that anxiety disorders are not merely isolated psychiatric conditions but rather a key hub in the broader continuum of interconnected diseases. In this disease-wide association study (DWAS), this study analyzed temporal and taxonomic patterns of comorbidities in a cohort including 40,191 patients clinically diagnosed with anxiety disorders (ICD‑10 codes: F40–F48). Applying Cox proportional hazards regression and controlling false discoveries (FDR &lt; 0.05), this study identified significant associations across diverse disease categories, including cardiovascular, oncologic, musculoskeletal, digestive, neurological, endocrine, nutritional, and metabolic diseases. Two distinct temporal patterns emerged: psychiatric and neurological disorders (such as depression, bipolar disorder, schizophrenia, epilepsy) frequently preceded anxiety diagnosis, suggesting they may represent early sentinel risk factors, while chronic somatic conditions (including cancer, chronic kidney disease, osteoporosis, pulmonary embolism, dementia, and fibromyalgia) typically followed anxiety, highlighting anxiety’s potential role in exacerbating physical morbidity. These temporal relationships underscore anxiety's dual role as both consequence and contributor within a dynamic disease network. Clinically, the identification of anxiety as a transdiagnostic hub demands integrated care models, promoting early anxiety screening in at-risk populations and proactive medical monitoring after anxiety diagnosis. Mechanistically, the potential shared pathological pathways—such as chronic inflammation, metabolic disruption, Hypothalamic-Pituitary-Adrenal (HPA)-axis dysregulation, and autonomic imbalance—support dimensional frameworks like the NIMH's Research Domain Criteria (RDoC), underscoring the need for precision psychiatry approaches. Overall, positioning anxiety disorders within this disease continuum framework offers promising avenues for improved risk stratification, targeted intervention, and holistic management strategies addressing both mental and physical health outcomes.</p>

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Mapping the disease continuum of anxiety disorder

  • 期刊论文

  • 发表日期：

    2025年12月17日

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  • Ming Zheng

摘要

Emerging evidence indicates that anxiety disorders are not merely isolated psychiatric conditions but rather a key hub in the broader continuum of interconnected diseases. In this disease-wide association study (DWAS), this study analyzed temporal and taxonomic patterns of comorbidities in a cohort including 40,191 patients clinically diagnosed with anxiety disorders (ICD‑10 codes: F40–F48). Applying Cox proportional hazards regression and controlling false discoveries (FDR < 0.05), this study identified significant associations across diverse disease categories, including cardiovascular, oncologic, musculoskeletal, digestive, neurological, endocrine, nutritional, and metabolic diseases. Two distinct temporal patterns emerged: psychiatric and neurological disorders (such as depression, bipolar disorder, schizophrenia, epilepsy) frequently preceded anxiety diagnosis, suggesting they may represent early sentinel risk factors, while chronic somatic conditions (including cancer, chronic kidney disease, osteoporosis, pulmonary embolism, dementia, and fibromyalgia) typically followed anxiety, highlighting anxiety’s potential role in exacerbating physical morbidity. These temporal relationships underscore anxiety's dual role as both consequence and contributor within a dynamic disease network. Clinically, the identification of anxiety as a transdiagnostic hub demands integrated care models, promoting early anxiety screening in at-risk populations and proactive medical monitoring after anxiety diagnosis. Mechanistically, the potential shared pathological pathways—such as chronic inflammation, metabolic disruption, Hypothalamic-Pituitary-Adrenal (HPA)-axis dysregulation, and autonomic imbalance—support dimensional frameworks like the NIMH's Research Domain Criteria (RDoC), underscoring the need for precision psychiatry approaches. Overall, positioning anxiety disorders within this disease continuum framework offers promising avenues for improved risk stratification, targeted intervention, and holistic management strategies addressing both mental and physical health outcomes.