Association between Early-Onset Metabolic Diseases and Adverse Mental Health Conditions: A Nationwide Cross-Sectional Study

Abstract

Purpose Though metabolic diseases increasingly affect younger populations, their mental health implications remain poorly understood. We examined associations between age at metabolic disease diagnosis and mental health conditions, comparing early-onset (age <40 years) and late-onset (age ≥40 years) cases. Materials and Methods We analyzed the 2014–2023 Korea National Health and Nutrition Examination Survey. Participants reported physician-diagnosed hypertension, diabetes, or dyslipidemia, with age at diagnosis. Mental health conditions included depression, perceived stress, and suicidality. Depression was assessed using the Patient Health Questionnaire-9, perceived stress through self-reported daily experiences, and suicidality as the presence of suicidal ideation, planning, or attempts within the past year. Associations were examined using multiple logistic regression with Bonferroni correction. Results Early-onset hypertension [odds ratio (OR)=2.67; 95% confidence interval (CI): 1.91–3.74] and dyslipidemia (OR=2.55; 95% CI: 1.71–3.79) showed higher odds of depression compared to undiagnosed and late-onset cases (p-diff.<0.001 and p-diff.=0.001, respectively). Early-onset hypertension (OR=1.41; 95% CI: 1.21–1.66) and dyslipidemia (OR=1.90; 95% CI: 1.59–2.26) showed higher odds of perceived stress compared to undiagnosed and late-onset cases (both p-diff.<0.001). Early-onset diabetes (OR=2.76; 95% CI: 1.79–4.25) showed higher odds of suicidality compared to undiagnosed and late-onset cases (p-diff.<0.001). Conclusion Early-onset metabolic diseases showed stronger associations with adverse mental health conditions than late-onset cases, with patterns suggesting these associations were not primarily explained by disease duration. While the cross-sectional design limits causal inference, mental health screening in early-onset metabolic disease care could be considered.