Excess mortality in anxiety and depression has mostly been studied for diagnostic categories of each condition separately. The aim of this article is to study the association between self-reported mixed anxiety and depression and mortality in the general population. A population survey of 2624 individuals was defined in three groups according to their total score on Hospital Anxiety and Depression rating Scale (HADS-T): 0-19 points, 19-24 points and 25 points or above; 114 deaths (4.3%) occurred during 4.5 years. Only the highest score group had increased mortality risk after adjustment for all relevant confounding factors (P=0.043). However, trend tests supported a dose-response relationship between increasing HADS-T score and increasing total mortality across the three groups (P for trend = 0.02). All seven suicides occurred in cases detected by HADS-T (>or=19 points) at baseline. Our sample is limited and the findings therefore tentative, yet there seems to a positive correlation between HADS-T symptom level and total mortality risk in a 4.5-year perspective.