This nationwide cross-sectional analysis assessed whether the age at diagnosis of common metabolic diseases—hypertension, diabetes, and dyslipidemia—is associated with adverse mental health outcomes. The authors compared early-onset metabolic diseases (diagnosis before age 40) with late-onset disease (diagnosis at age 40 or older) and with undiagnosed participants to evaluate differences in depression, perceived stress, and suicidality.
The analysis used pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES) covering 2014 through 2023. Participants self-reported whether they had been diagnosed by a physician with hypertension, diabetes, or dyslipidemia and provided the age at diagnosis. The source abstract does not report sample size, inclusion/exclusion criteria, or detailed demographic breakdowns; those details were not reported in the abstract.
Early-onset cases were defined as diagnosis before age 40; late-onset cases were defined as diagnosis at age 40 or older. Mental health outcomes included:
Depression was identified using the PHQ-9 instrument as described in the abstract. Perceived stress relied on participants' self-report of daily stress experiences. Suicidality encompassed ideation, planning, or attempts in the prior 12 months. The abstract does not provide cutoffs, scoring thresholds, or prevalence estimates for these measures.
Associations between age at diagnosis of each metabolic disease and mental health outcomes were estimated using multiple logistic regression models. The investigators applied a Bonferroni correction for multiple comparisons. The abstract does not specify covariates included in the models, model-building strategy, or handling of missing data; those details were not reported in the abstract.
Compared with undiagnosed participants and late-onset cases, early-onset metabolic disease showed stronger associations with depression for two conditions:
The abstract reports these elevated odds specifically for depression among early-onset hypertension and dyslipidemia relative to both undiagnosed participants and late-onset disease.
Early-onset hypertension and early-onset dyslipidemia were also associated with higher odds of perceived stress compared with undiagnosed and late-onset cases:
These findings indicate increased self-reported daily stress in people with early-onset hypertension or dyslipidemia compared with the reference groups.
Early-onset diabetes was associated with higher odds of suicidality compared with undiagnosed and late-onset cases:
Suicidality in this study was operationalized as suicidal ideation, planning, or attempts in the prior year.
The authors note that the observed patterns suggest the stronger associations for early-onset metabolic diseases were not primarily explained by longer disease duration. However, because the study is cross-sectional, causal inference is limited; the temporal sequence between metabolic disease onset and mental health outcomes cannot be established from the data presented in the abstract.
Conclusions reported in the abstract: early-onset hypertension, dyslipidemia, and diabetes were more strongly associated with adverse mental health outcomes—depression, perceived stress, and suicidality—than late-onset cases. The authors suggest that mental health screening could be considered in the care of patients with early-onset metabolic disease.
Limitations stated or implied in the abstract include the cross-sectional design, which precludes causal claims. The abstract does not provide detailed information on covariate adjustment, sample size, absolute prevalences, or subgroup analyses; those methodological details were not reported in the abstract. Conflict of interest: the authors declared no potential conflicts of interest.
Clinicians and public health practitioners should be aware that, in this KNHANES-based analysis, metabolic disease diagnosed before age 40 was associated with higher adjusted odds of depression, perceived stress, and suicidality compared with late-onset or undiagnosed individuals. The findings support consideration of mental health assessment in patients with early-onset metabolic conditions, while recognizing that longitudinal studies are needed to establish causality and to explore mechanisms and potential interventions.