{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:56:20Z","timestamp":1791287780014,"version":"4.3.0"},"reference-count":206,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World Psychiatry"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Anxiety disorders are the most prevalent mental health conditions worldwide. While their burden in terms of excess mortality is known to be high, a quantitative systematic evaluation of all\u2010cause and cause\u2010specific mortality and suicide attempt risks in people with anxiety or stress\u2010related disorders is lacking. We performed a systematic review and random effects meta\u2010analysis, in which co\u2010primary outcomes were risk ratios (RRs) for all\u2010cause and suicide\u2010related mortality, and secondary outcomes were natural\u2010cause mortality, other cause\u2010specific mortality, and risk of suicide attempt. Sensitivity and meta\u2010regression analyses were conducted. Overall, 165 studies encompassing 7,395,722 people with any anxiety or stress\u2010related disorder and 135,059,023 controls, from 27 different countries across all continents, were included. Compared with the general population, a higher risk of all\u2010cause mortality was associated with any anxiety or stress\u2010related disorder (n=42, RR=1.54, 95% CI: 1.14\u20102.08, p=0.005), generalized anxiety disorder (n=9, RR=1.48, 95% CI: 1.23\u20101.78, p&lt;0.001), and post\u2010traumatic stress disorder (PTSD) and other stress\u2010related disorders (n=21, RR=1.39, 95% CI: 1.15\u20101.67, p&lt;0.001), but not with panic disorder, phobias, and mixed anxiety or stress\u2010related disorders. Suicide mortality was increased in people with any anxiety or stress\u2010related disorder (n=39, RR=2.88, 95% CI: 2.13\u20103.89, p&lt;0.001), panic disorder (n=3, RR=3.58, 95% CI: 1.39\u20109.25, p&lt;0.008), mixed anxiety or stress\u2010related disorders (n=27, RR=2.77, 95% CI: 1.89\u20104.07, p&lt;0.001), PTSD and other stress\u2010related disorders (n=11, RR=3.13, 95% CI: 1.85\u20105.28, p&lt;0.001), and generalized anxiety disorder (n=3, RR=1.93, 95% CI: 1.17\u20103.17, p&lt;0.01). Suicide attempt risk was higher than in the general population in people with all anxiety or stress\u2010related disorders, ranging from RR=6.33 (95% CI: 4.08\u20109.82, n=5) in panic disorder to RR=2.74 (95% CI: 1.72\u20104.35, n=5) in phobias. Natural\u2010cause mortality was increased in any anxiety or stress\u2010related disorder (n=19, RR=1.25, 95% CI: 1.09\u20101.44, p=0.002), generalized anxiety disorder (n=5, RR=1.55, 95% CI: 1.19\u20102.02, p=0.001), mixed anxiety or stress\u2010related disorders (n=8, RR=1.26, 95% CI: 1.02\u20101.56, p=0.033), and PTSD and other stress\u2010related disorders (n=9, RR=1.17, 95% CI: 1.03\u20101.33, p=0.019), but not in panic disorder. Cardiovascular\u2010related deaths were increased in any and mixed anxiety or stress\u2010related disorders and in generalized anxiety disorder, while cancer mortality was increased only in generalized anxiety disorder. When analyzing people with vs. without anxiety disorders with samples being matched by comorbid physical or mental disorders, results remained significant for all\u2010cause mortality in generalized anxiety disorder and panic disorder, but not in any or mixed anxiety or stress\u2010related disorders, and in PTSD and stress\u2010related disorders. When compared with other mental disorders, no difference in co\u2010primary outcomes emerged from more than two studies. Publication bias was present across several analyses, but sensitivity analyses largely confirmed the main findings. In meta\u2010regression analyses, more recent data collection mitigated all\u2010cause mortality, while schizophrenia\u2010spectrum and bipolar disorder comorbidity mitigated suicide mortality risk, possibly driven by underlying treatment. This meta\u2010analysis documents a higher all\u2010cause, suicide and natural\u2010cause mortality, and a higher risk of suicide attempt, in people with anxiety or stress\u2010related disorders compared to the general population. Given the high prevalence and the recognized global treatment gap for these disorders, this finding is of great public health concern, and calls for appropriate prevention, screening and treatment strategies. More studies are needed to fill the publication bias gap and to identify modifiable risk or mitigating factors.<\/jats:p>","DOI":"10.1002\/wps.70072","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T07:48:21Z","timestamp":1778831301000},"page":"307-320","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of all\u2010cause and cause\u2010specific mortality, and suicide attempt in people with anxiety and stress\u2010related disorders: a systematic review, meta\u2010analysis and meta\u2010regression analysis of 165 studies"],"prefix":"10.1002","volume":"25","author":[{"given":"Elias","family":"Wagner","sequence":"first","affiliation":[{"name":"Evidence\u2010based Psychiatry and Psychotherapy, Faculty of Medicine University of Augsburg  Augsburg Germany"},{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty University of Augsburg  BKH Augsburg 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