OBJECTIVE: To examine whether the 1-year prevalence of major depressive disorder 
(MDD), generalized anxiety disorder (GAD), and their comorbidity were associated 
with subsequent all-cause and cardiovascular disease (CVD) mortality during 15 
years in Vietnam veterans.
METHODS: Participants (N = 4256) were from the Vietnam Experience Study. 
Service, sociodemographic, and health data were collected from service files, 
telephone interviews, and a medical examination. One-year prevalence of MDD and 
GAD was determined through a diagnostic interview schedule based on the 
Diagnostic and Statistical Manual of Mental Disorders (version IV) criteria. 
Mortality over the subsequent 15 years was gathered from US army records.
RESULTS: MDD and GAD were positively and significantly associated with all-cause 
and CVD mortality. The relationships between MDD and GAD and CVD mortality were 
no longer significant after adjustment for sociodemograhics, health status at 
entry, health behaviors, and other risk markers. Income was the covariate with 
the strongest impact on this association. In analyses comparing comorbidity and 
GAD and MDD alone, with neither diagnosis, comorbidity proved to be the 
strongest predictor of both all-cause and CVD mortality.
CONCLUSION: GAD and MDD predict all-cause mortality in a veteran population 
after adjusting for a range of covariates. However, those with both GAD and MDD 
were at greatest risk of subsequent death, and it would seem that these 
disorders may interact synergistically to affect mortality. Future research on 
mental disorders and health outcomes, as well as future clinical interventions, 
should pay more attention to comorbidity.