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Mental health problems cause of unhealthy lifestyle, not vice versa


Poor mental health leads to bad lifestyle behaviour in socially disadvantaged people - not the other way round, a study suggests.

Binge drinking, smoking, illegal drug use, poor diet and unsafe sex could all be coping strategies for dealing with depression and anxiety, according to psychologists.

The research turns on its head the idea that unhealthy lifestyle might explain high rates of mental health problems among deprived sections of society.

Scientists studied a group of 482 adults receiving care at a sexually transmitted disease clinic in the US.

Patients completed online questionnaires to assess their lifestyle, and were tested for levels of anxiety, depression and perceived stress.

Those with low incomes were more likely to display unhealthy behaviours than those with high incomes, and also had higher rates of mental problems.

The study found that depression, anxiety and stress tended to herald unhealthy behaviour. In contrast, unhealthy behaviour did not predict poor mental health.

The findings, published in the journal Translational Behavioural Medicine, suggest that unhealthy behaviour follows mental conditions but does not necessarily give rise to them.

Dr Jennifer Walsh, from the Miriam Hospital, in Providence, Rhode Island, and colleagues wrote: “Clinicians and practitioners should recognise that there may be high rates of depression, anxiety and stress, as well as health-compromising behaviours, in low income populations, and they should assess mental health as well as these behaviours.”

Offering patients mental health counselling or stress reduction may help them improve their lifestyles, said the researchers.


Readers' comments (6)

  • 'Unhealthy behaviours' - this smacks of the paternalism that MH service users are sadly familiar with:( - no change there then!!!

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  • yet another finger to wag!

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  • Binge drinking, smoking, illegal drug use, poor diet and unsafe sex..are you two saying that these are "healthy" behaviours? It seems a really balanced article, its NOT paternalistically blaming people for their unhealthy lifestyles but realising that underlying mental health issues can have an effect on life choices, what's wrong with that?

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  • Keith Edwards

    Poor mental health leads to 'bad lifestyle behaviour', yes possibly a contributing factor. However, there is also a wealth of research that clearly shows that poor mental health is a result of poverty, low income, poor social conditions, inequalities, run down environments, lack of supportive resources and services, poor education and unemployment amongst many other issues. I do find it difficult to take the above paper seriously and it sound like another attempt to victim blame rather than to look at people within the context of their lives.

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  • I think it depends up the type of research that it carried out. Whether the researcher it trying to prove a theory that already exist or looking beyond this and looking outside of the already existing box. If the latter, it would be hard to prove or fit an existing theory by leading the questions in the direction of the pre-existing theory. I have read enough of this over the years to know this happens. Although I would question Kieth's beliefs pre-existing research theory,I am not disputing all of the conditions listed would impact upon a person. But there is also a lot of research that indicates that many people who experience mental illness are highly intelligent and not poorly educated. It does not always follow that living conditions are only to blame for a persons mental health, even members of the royal family have suffered mental illness!! So what this article is saying makes sense.

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  • funnily enough, i thought this was the least finger wagging article on unhealthy lifestyles i'd read in a while.

    IF a healthy person chooses an unhealthy lifestyle, then complains of anxiety/depression some people (not a healthcare professional, i hope) might feel finger wagging is in order.

    but IF a healthy person, leading a healthy lifestyle, starts to complain of anxiety/depression, and THEN engages in an unhealthy lifestyle, finger wagging would (according to this article) seem totally out of order.

    basically, if somebody keeps turning up at casualty with binge drinking related injuries, is it really "finger wagging" to ask them to fill in an hospital anxiety and depression scale?


    @Keith Edwards | 18-Feb-2013 11:52 am

    perhaps offering someone citalopram rather than gainful employment or a purpose in life might smack of social control or at least the cheapest option. of course, most nurses don't have a resus bag full of job offers or meaningful existence to offer the mentally ill leading unhealthy lifestyles. but those of us in the nhs are part of the state apparatus (whether we like it or not) and maybe the government, rather than dealing with the social conditions that cause the poor to experience higher rates of anxiety/depression leading to poor lifestyle choices, is subverting our compassionate attitude into placating the poor with pills!

    still, not sure where this paper "victim blames." surely the "research turns on its head" paragraph is wagging it's finger at the notion that mental illness results from poor choices? or am i completely mis-reading it??

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