The Impact of Cognitive Flexibility and Cognitive Control on Turnover Intention: The Roles of Impulsivity and Anger Expression Among Emergency Nurses.

Major depressive disorder (MDD) is a highly prevalent disease with profound effects on individual well-being. It is frequently accompanied by metabolic comorbidities and an increased risk of cardiovascular disease []. Obesity, alongside depression, represents a leading cause of disability [, ] and shares overlapping mechanisms with affective disorders [, ]. Overweight, and especially obesity, elevates the risk for various chronic conditions, including cancer [], type 2 diabetes mellitus [], atherosclerosis [], arthrosis [], or chronic inflammatory conditions, such as asthma []. Similar associations are well known for depression [, ] and a bidirectional relationship between depression and obesity has been described []. Smoking is another critical factor in this context. Nicotine use often serves as a maladaptive strategy to cope with emotional distress []. Individuals with mental illness are twice as likely to use tobacco (WHO []). MDD is associated with a lower likelihood of smoking cessation and higher relapse rates []. In females, stress promotes tobacco use vulnerability [], while smoking and stress are critical sex-specific markers for increased MDD risk in women []. Anxiety symptoms again can be both a risk factor for, and a consequence of, depression []. When they co-occur, they form a complex clinical phenotype with heightened somatic symptoms, and greater disease severity [, , ]. Comorbid anxiety exacerbates metabolic dysregulation []. In women, those effects may be particularly pronounced due to sex-specific hormonal influences [].