Longitudinal relationships among number of chronic diseases, depression, and anxiety: A cross-lagged model analyses

Background: Research is increasingly highlighting the intricate relationship between mental and physical health. However, longitudinal studies investigating the interplay between chronic diseases (CDs), depression and anxiety are still relatively scarce. This study aimed to delve into the longitudinal connections among these variables. Methods: This study conducted a 4-year prospective survey involving 486 participants from rural communities in Shandong Province, China. The relationships among these variables were analyzed using multiple linear regression, cross-lagged path analysis, and multiple-group analysis. Results: Our analysis revealed that the number of CDs reported at wave 1 significantly predicted anxiety levels ((3 = 0.126, p < .01) at wave 2, while depression symptoms also predicted anxiety ((3 = 0.220, p < .01) at wave 2. Furthermore, anxiety levels at wave 1 significantly predicted both the number of CDs ((3 = 0.219, p < .01) and depression symptoms ((3 = 0.160, p < .05) at wave 2. However, the study did not find support for a relationship between CDs and depression. Conclusion: The study uncovered a bidirectional association between CDs and anxiety, depression and anxiety, but found no direct longitudinal relationship between CDs and depression. Research has indicated that CDs indirectly affect depression through anxiety.