Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression

Scott, Kate M.; Alonso Caballero, Jordi; Girolamo, Giovanni de; Kessler, Ronald C.

doi:http://dx.doi.org/10.1016/j.ijcard.2013.08.012

Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression

Citation

Scott KM, de Jonge P, Alonso J, Viana MC, Liu Z, O'Neill S et al. Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression. Int J Cardiol. 2013 Oct 15;168(6):5293-9. DOI: 10.1016/j.ijcard.2013.08.012

Abstract

BACKGROUND: Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, or taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown. METHODS: Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician's diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset. RESULTS: After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3-1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender. CONCLUSIONS: Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology's links with heart disease onset has substantial clinical and public health implications.