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AGGIORNAMENTI DA PUBMED

COMORBIDITA'' CARDIOVASCOLARI

1 2015

Stringa di ricerca: (CARDIOVASCULAR OR CARDIOLOGY OR CARDIOLOGICAL OR 'HEART DISEASE' OR 'HEART DISEASES') AND (PSYCHIATRY OR PSYCHIATRIC OR DEPRESSION OR PSYCHOSIS OR BIPOLAR OR SCHIZOPHRENIA OR MOOD DISORDERS)

Filters: Publication date from 2015/04/20 to 2015/06/19

 

1.         J Affect Disord. 2015 Aug 15;182:126-31. doi: 10.1016/j.jad.2015.03.044. Epub 2015 Apr 24.

Aspirin and statin use and the subsequent development of depression in men and women: Results from a longitudinal population-based study.

Glaus J1, Vandeleur CL2, Lasserre AM3, Strippoli MP3, Castelao E3, Gholam-Rezaee M3, Waeber G4, Aubry JM5, Vollenweider P4, Preisig M3.

Author information:

•  1Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Site de Cery, CH-1008 Prilly, Switzerland; Department of Mental Health and Psychiatry, Geneva University Hospital, Site de Belle-Idée, Chêne-Bourg, CH-1225 Geneva, Switzerland.

•  2Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Site de Cery, CH-1008 Prilly, Switzerland. Electronic address: Caroline.Vandeleur@chuv.ch.

•  3Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, Department of Psychiatry, Site de Cery, CH-1008 Prilly, Switzerland.

•  4Department of Internal Medicine, Lausanne University Hospital, Bâtimenthospitalier, Rue du Bugnon 46 CH-1011 Lausanne, Switzerland.

•  5Department of Mental Health and Psychiatry, Geneva University Hospital, Site de Belle-Idée, Chêne-Bourg, CH-1225 Geneva, Switzerland.

Abstract

OBJECTIVE:

Low-grade chronic inflammation is one potential mechanism underlying the well-established association between major depressive disorder (MDD) and increased cardiovascular morbidity. Both aspirin and statins have anti-inflammatory properties, which may contribute to their preventive effect on cardiovascular diseases. Previous studies on the potentially preventive effect of these drugs on depression have provided inconsistent results. The aim of the present paper was to assess the prospective association between regular aspirin or statin use and the incidence of MDD.

METHOD:

This prospective cohort study included 1631 subjects (43.6% women, mean age 51.7 years), randomly selected from the general population of an urban area. Subjects underwent a thorough physical evaluation as well as semi-structured interviews investigating DSM-IV mental disorders at baseline and follow-up (mean duration 5.2 years). Analyses were adjusted for a wide array of potential confounders.

RESULTS:

Our main finding was that regular aspirin or statin use at baseline did not reduce the incidence of MDD during follow-up, regardless of sex or age (hazard ratios, aspirin: 1.19; 95%CI, 0.68-2.08; and statins: 1.25; 95%CI, 0.73-2.14; respectively).

LIMITATIONS:

Our study is not a randomized clinical trial and could not adjust for all potential confounding factors, information on aspirin or statin use was collected only for the 6 months prior to the evaluations, and the sample was restricted to subjects between 35 and 66 years of age.

CONCLUSION:

Our data do not support a large scale preventive treatment of depression using aspirin or statins in subjects aged from 35 to 66 years from the community.

Copyright © 2015 Elsevier B.V. All rights reserved.

           

 

           

2.         J Affect Disord. 2015 Aug 1;181:1-8. doi: 10.1016/j.jad.2015.04.004. Epub 2015 Apr 11.

Predictors of depressive disorder following acute coronary syndrome: Results from K-DEPACS and EsDEPACS.

Kang HJ1, Stewart R2, Bae KY1, Kim SW1, Shin IS1, Hong YJ3, Ahn Y3, Jeong MH3, Yoon JS1, Kim JM4.

Author information:

•  1Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.

•  2King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

•  3Departments of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.

•  4Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea. Electronic address: jmkim@chonnam.ac.kr.

Abstract

INTRODUCTION:

Depression is common and associated with poor prognosis in acute coronary syndrome (ACS). There are few reports on the predictors of incident and persistent post-discharge depressive disorders in ACS. This study aimed to investigate the incidence and persistence of depressive disorder over a one year follow-up, and predictors of these outcomes.

METHODS:

1152 patients with recently developed ACS were recruited at baseline, and 828 were followed one year thereafter. Depressive disorder (major and minor) was diagnosed according to DSM-IV criteria, and analyzed according to baseline prevalence, and follow up incidence and persistence. Of 446 baseline participants with depressive disorders, 300 were randomized to a 24-week double blind trial of escitalopram or placebo, while the remaining 146 received medical treatment as usual. Associations of baseline socio-demographic and clinical characteristics with depressive disorder were investigated using logistic regression models.

RESULTS:

Two-week prevalence, and one-year incidence and persistence of depressive disorder were 38.7%, 13.1%, and 46.3%, respectively. Baseline depressive disorder was independently associated with female, lower educational level, previous ACS and higher heart rate. Incident depressive disorder was independently predicted by current unemployment, family history of depression, higher baseline Hamilton Depression Rating Scale(HAMD) score and lower left ventricular ejection fraction, and persistent depressive disorder by higher baseline HAMD score and the placebo or medical treatment as usual group in the 24-week trial.

LIMITATIONS:

The generalizability should be considered since this study conducted in a single center.

CONCLUSIONS:

Depressive disorder in ACS patients is common and often persistent, and is associated with baseline characteristics and insufficient treatment. Appropriate detection and treatment of depressive disorder are clearly important in ACS patients.

Copyright © 2015 Elsevier B.V. All rights reserved.

           

3.         Metabolism. 2015 Aug;64(8):926-933. doi: 10.1016/j.metabol.2015.04.009. Epub 2015 May 6.

The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis.

Rosenbaum S1, Stubbs B2, Ward PB1, Steel Z1, Lederman O1, Vancampfort D3.

Author information:

•  1School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.

•  2School of Health and Social Care, University of Greenwich, Southwood Site Avery Hill Road, Eltham, London, UK.

•  3Department of Neurosciences, UPC KU Leuven, Campus Kortenberg, KU Leuven-University of Leuven, Kortenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium. Electronic address: davy.vancampfort@uc-kortenberg.be.

Abstract

OBJECTIVE:

People with posttraumatic stress disorder (PTSD) have a higher mortality than the general population, mainly due to cardiovascular diseases (CVD). Metabolic syndrome (MetS) and its components are highly predictive of CVD. The aim of this meta-analysis was to describe pooled frequencies of MetS and its components in people with PTSD and to compare MetS prevalence in PTSD versus the general population.

METHOD:

Medline, PsycARTICLES, Embase and CINAHL were searched until 02/2015 for cross-sectional and baseline data of longitudinal studies in adults with PTSD. Two independent reviewers conducted the searches and extracted data. Random effects meta-analysis with a relative risk, subgroups and meta-regression analyses were employed.

RESULTS:

Overall, 9 studies met the inclusion criteria including 9,673 individuals in midlife with PTSD and 6852 general population controls. The pooled MetS prevalence was 38.7% (95% CI=32.1%-45.6%; Q=52.1, p<0.001; N=9; n=9,673; age range=44-61years). Abdominal obesity was observed in 49.3% (95% CI=29.7%-69.0%), hyperglycemia in 36.1% (95% CI=18.8%-55.6%), hypertriglyceridemia in 45.9% (95% CI=12.2%-81.9%), low high density-lipoprotein-cholesterol in 46.4% (95% CI=26.4%-67.0%) and hypertension in 76.9% (95% CI=67.9%-84.8%). The MetS prevalence was consistently high across geographical regions, settings or populations (war veterans or not). Compared with matched general population controls, people with PTSD had an almost double increased risk for MetS (RR=1.82; 95% CI=1.72-1.92; p<0.001). Most analyses were not statistically heterogeneous.

CONCLUSIONS:

MetS is highly prevalent in people with PTSD. Routine screening and multidisciplinary management of medical and behavioral conditions is needed. Future research should focus on how cardio-metabolic outcomes are moderated by clinical and treatment characteristics and genetic factors.

Copyright © 2015 Elsevier Inc. All rights reserved.

           

4.         Patient EducCouns. 2015 Aug;98(8):935-42. doi: 10.1016/j.pec.2015.04.013. Epub 2015 Apr 27.

Internet-based cognitive behavior therapy for patients with heart failure and depressive symptoms: A proof of concept study.

Lundgren J1, Andersson G2, Dahlström Ö3, Jaarsma T4, Köhler AK5, Johansson P6.

Author information:

•  1Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. Electronic address: johan.lundgren@liu.se.

•  2Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. Electronic address: gerhard.andersson@liu.se.

•  3Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden. Electronic address: orjan.dahlstrom@liu.se.

•  4Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. Electronic address: tiny.jaarsma@liu.se.

•  5Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. Electronic address: anita.karner@liu.se.

•  6Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden; Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden. Electronic address: peter.johansson@aries.vokby.se.

Abstract

OBJECTIVE:

The aim was (1) to describe the development of a guided internet-based CBT (ICBT) program adapted to patients with heart failure (HF) and (2) to evaluate the feasibility of the ICBT program in regard to depressive symptoms, the time used by health care providers to give feedback, and participants' perceptions of the ICBT program.

METHOD:

A multi-professional team developed the program and seven HF patients with depressive symptoms were recruited to the study. The Patient Health Questionnaire-9 (PHQ-9) and the Montgomery Åsberg Depression Rating-Self-rating scale (MADRS-S) were used to measure depression, and patients were interviewed about their perceptions of the program.

RESULTS:

Based on research in HF and CBT, a nine-week program was developed. The median depression score decreased from baseline to the end of the study (PHQ-9: 11-8.5; MADRS-S: 25.5-16.5) and none of the depression scores worsened. Feedback from health care providers required approximately 3h per patient. Facilitating perceptions (e.g. freedom of time) and demanding perceptions (e.g. part of the program demanded a lot of work) were described by the patients.

CONCLUSION:

The program appears feasible and time-efficient. However, the program needs to be evaluated in a larger randomized study.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

           

5.         Int J Cardiol. 2015 Jul 15;191:71-3. doi: 10.1016/j.ijcard.2015.04.271. Epub 2015 May 2.

Psychiatric co-morbidities in patients with dilated cardiomyopathy.

Rasoul D1, Potluri S2, Wong SC1, Gorantla RS3, Aziz A4, Chandran S5, Uppal H6, Potluri R7.

Author information:

•  1Department of Medicine, Macclesfield District General Hospital, Macclesfield, UK.

•  2School of Medicine, Cardiff University, Cardiff, UK.

•  3Department of Internal Medicine, Bassett Medical Center, Columbia University of Physicians and Surgeons, Cooperstown, USA.

•  4Department of Cardiology, University of Birmingham, Birmingham, UK.

•  5Department of Acute Medicine, North Western Deanery, UK.

•  6ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK.

•  7ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK. Electronic address: rahulpotluri@outlook.com.

6.         Gen Hosp Psychiatry. 2015 Jul-Aug;37(4):288-93. doi: 10.1016/j.genhosppsych.2015.03.022. Epub 2015 Apr 7.

Depression and anxiety disorders and the link to physician diagnosed cardiac disease and metabolic risk factors.

Kinley DJ1, Lowry H2, Katz C3, Jacobi F4, Jassal DS5, Sareen J6.

Author information:

•  1Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.

•  2Department of Psychiatry, University of Saskatchewan, Saskatoon, Saschetchewan, Canada.

•  3Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.

•  4Department of Psychology, Technical University of Dresden, Dresden, Saxony, Germany.

•  5Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

•  6Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: sareen@cc.umanitoba.ca.

Abstract

OBJECTIVE:

There has been increasing interest in the relationship between cardiac and metabolic conditions with mental illness. Many studies have found associations between these conditions and depression but results with anxiety disorders have been mixed. We explore these relationships in a nationally representative survey using physician diagnoses of physical conditions and DSM-IV psychiatric disorders.

METHODS:

Data came from the nationally representative German Health Survey (N=4181, age 18-65). Physician diagnoses of angina, myocardial infarction, congestive heart, hypertension, dyslipidemia, diabetes, and obesity were examined in relation to depression and anxiety disorders, which were assessed through a modified version of the Composite International Diagnostic Interview. Multiple logistic regression analyses were used to examine the associations between these conditions.

RESULTS:

After adjusting for sociodemographics, psychiatric comorbidity, and substance use, having an anxiety disorder was associated with increased odds of cardiac conditions and metabolic risk factors with odds ratios ranging from 1.3 to 3.3. Depression was not associated with any of the conditions but was associated with poor medical compliance for health conditions on two outcomes measured. Anxiety was also associated with reduced medical compliance for one health behaviour measured.

CONCLUSION:

Anxiety disorders, but not depression, were associated with metabolic and cardiac conditions in our sample. Both conditions were related to some aspects of poor self-care for health conditions and therefore may be linked to negative outcomes.

Copyright © 2015 Elsevier Inc. All rights reserved.

           

 

           

7.         Int J Cardiol. 2015 Jul 1;190:360-6. doi: 10.1016/j.ijcard.2015.04.122. Epub 2015 Apr 16.

Metabolic syndrome, major depression, generalized anxiety disorder, and ten-year all-cause and cardiovascular mortality in middle aged and elderly patients.

Butnoriene J1, Bunevicius A2, Saudargiene A3, Nemeroff CB4, Norkus A1, Ciceniene V5, Bunevicius R6.

Author information:

•  1Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

•  2Institute of Neurosciences, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: a.bunevicius@yahoo.com.

•  3Department of Informatics, Vytautas Magnus University, Kaunas, Lithuania.

•  4Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

•  5Institute of Hygiene, Vilnius, Lithuania.

•  6Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.

Abstract

BACKGROUND:

Studies investigating specifically whether metabolic syndrome (MetS) and common psychiatric disorders are independently associated with mortality are lacking. In a middle-aged general population, we investigated the association of the MetS, current major depressive episode (MDE), lifetime MDE, and generalized anxiety disorder (GAD) with ten-year all-cause and cardiovascular disease mortality.

METHODS:

From February 2003 until January 2004, 1115 individuals aged 45years and older were randomly selected from a primary care practice and prospectively evaluated for: (1) MetS (The World Health Organization [WHO], National Cholesterol Education Program/Adult Treatment Panel III and International Diabetes Federation [IDF] definitions); (2) current MDE and GAD, and lifetime MDE (Mini International Neuropsychiatric Interview); and (3) conventional cardiovascular risk factors. Follow-up continued through January, 2013.

RESULTS:

During the 9.32±0.47years of follow-up, there were 248 deaths, of which 148 deaths were attributed to cardiovascular causes. In women, WHO-MetS and IDF-MetS were associated with greater all-cause (HR-values range from 1.77 to 1.91; p-values≤0.012) and cardiovascular (HR-values range from 1.83 to 2.77; p-values≤0.013) mortality independent of cardiovascular risk factors and MDE/GAD. Current GAD predicted greater cardiovascular mortality (HR-values range from 1.86 to 1.99; p-values≤0.025) independently from MetS and cardiovascular risk factors. In men, the MetS and MDE/GAD were not associated with mortality.

CONCLUSIONS:

In middle aged women, the MetS and GAD predicted greater 10-year cardiovascular mortality independently from each other; 10-year all-cause mortality was independently predicted by the MetS. MetS and GAD should be considered important and independent mortality risk factors in women.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

           

8.         Int J Cardiol. 2015 Jul 1;190:114-21. doi: 10.1016/j.ijcard.2015.04.164. Epub 2015 Apr 21.

Effects of depression screening on psychiatric outcomes in patients with acute coronary syndrome: Findings from the K-DEPACS and EsDEPACS studies.

Kang HJ1, Stewart R2, Bae KY1, Kim SW1, Shin IS1, Hong YJ3, Ahn Y3, Jeong MH3, Yoon JS1, Kim JM4.

Author information:

•  1Department of Psychiatry, Chonnam National University Medical School, Kwangju, Republic of Korea.

•  2King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

•  3Department of Cardiology, Chonnam National University Medical School, Kwangju, Republic of Korea.

•  4Department of Psychiatry, Chonnam National University Medical School, Kwangju, Republic of Korea. Electronic address: jmkim@chonnam.ac.kr.

Abstract

BACKGROUND:

It has been controversial whether routine screening for depression should be recommended in all patients with acute coronary syndrome (ACS) due to lack of evidence for psychiatric as well as for cardiac outcomes. This study aimed to evaluate the result of screening for treatment and subsequent treatment of depression on one-year psychiatric outcomes in ACS.

METHODS:

At baseline 1152 patients with recently developed ACS were screened with the Beck Depression Inventory (BDI) and depressive disorder diagnoses were applied according to DSM-IV criteria. Of the 446 patients with depressive disorder, 300 were randomized to a 24-week double-blind trial of escitalopram or placebo, while the remaining 146 received conventional medical treatment only (MTO) without randomization. Of all baseline participants, 828 were followed up one year later. Psychiatric outcomes included BDI, Hamilton Depression Rating Scale (HAMD), Montgomery Asberg Depression Rating Scale (MADRS), Social and Occupational Functioning Assessment Scale (SOFAS) and the World Health Organization Disability Assessment Schedule-12 (WHODAS-12).

RESULTS:

BDI screen-positive ACS patients showed worse one-year outcomes on MADRS, SOFAS, and WHODAS scores (p-values<0.01) compared to BDI screen-negative patients. Escitalopram treatment was associated with beneficial effects compared to placebo and MTO on one-year outcomes on HAMD, MADRS and SOFAS (p-values<0.01). Of patients screening positive on the BDI, those with depressive disorder treated with escitalopram had similar outcomes to those without depressive disorder.

CONCLUSIONS:

Routine screening of depressive symptom in ACS patients is helpful to plan further management. Moreover, successive accurate diagnosis of depressive disorder with appropriated treatment is effective at least for psychiatric outcomes.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

 

9.         Arch Cardiovasc Dis. 2015 Jun 11. pii: S1875-2136(15)00074-1. doi: 10.1016/j.acvd.2015.03.005. [Epub ahead of print]

Social support and the consequences of heart failure compared with other cardiac diseases: The contribution of support received within an attachment relationship.

Maunder RG1, Nolan RP2, Park JS3, James R4, Newton G5.

Author information:

•  1Department of Psychiatry, Mount Sinai Hospital, Room 915, Mount Sinai Hospital, 600, University Avenue, M5G 1X5 Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada. Electronic address: rmaunder@mtsinai.on.ca.

•  2Faculty of Medicine, University of Toronto, Toronto, Canada; Behavioural Cardiology Research Unit, University Health Network, Toronto, Canada.

•  3Department of Psychiatry, Mount Sinai Hospital, Room 915, Mount Sinai Hospital, 600, University Avenue, M5G 1X5 Toronto, Ontario, Canada.

•  4Department of Cardiology, North York General Hospital, Toronto, Canada.

•  5Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Cardiology, Mount Sinai Hospital, Toronto, Canada.

Abstract

BACKGROUND:

Interpersonal support is protective in heart disease, but sources of support and the quality of support may change over time, especially with aging and disease progression.

AIMS:

To determine if support received within an attachment relationship with a spouse is more protective than other types.

METHODS:

Subjects were sex- and age-matched cardiac outpatients with (n=40) or without (n=43) heart failure; they were studied with an observer-rated measure of attachment and self-report measures of other variables.

RESULTS:

Having heart failure was associated with more depressive symptoms and illness intrusiveness. Although perceived social support did not differ in people with or without heart failure, those with heart failure had a spouse as the primary source of attachment functions less frequently than those without heart failure (50% vs 79%; P=0.006). Not having a spouse as the main provider of attachment functions was a partial mediator of the relationship between disease type (heart failure or no heart failure) and depressive symptoms (β=-0.24, t=-2.2; P=0.03) and deficits in non-attachment support made a further independent contribution (β=-0.24, t=-2.4; P=0.02). Neither perceived social support nor having a spouse serving attachment needs made a significant contribution to illness intrusiveness.

CONCLUSION:

Having someone other than a spouse to provide attachment support is more common in cardiac patients who have heart failure and is associated with an increased risk of depressive symptoms.

Copyright © 2015 Elsevier Masson SAS. All rights reserved.

           

10.       Bipolar Disord. 2015 Jun 9.doi: 10.1111/bdi.12302. [Epub ahead of print]

Association between history of psychosis and cardiovascular disease in bipolar disorder.

Prieto ML1,2, McElroy SL3,4, Hayes SN5, Sutor B1, Kung S1, Bobo WV1, Fuentes ME6, Cuellar-Barboza AB7, Crow S8, Ösby U9, Chauhan M1, Westman J9, Geske JR10, Colby CL10, Ryu E10, Biernacka JM1,10, Frye MA1.

Author information:

•  1Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Rochester, MN, USA.

•  2Departamento de Psiquiatría, Facultad de Medicina, Universidad de los Andes, Santiago, Chile.

•  3LindnerCenter of HOPE, Mason, OH, USA.

•  4Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

•  5Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.

•  6Department of Psychiatry, Facultad de MedicinaClínicaAlemana/Universidad del Desarrollo, Santiago, Chile.

•  7Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México.

•  8Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.

•  9Department of Psychiatry, KarolinskaInstitutet, Stockholm, Sweden.

•  10Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA.

Abstract

OBJECTIVES:

To determine whether clinical features of bipolar disorder, such as history of psychosis, and cardiovascular disease (CVD) risk factors contribute to a higher risk of CVD among patients with bipolar disorder.

METHODS:

This cross-sectional study included a sample of 988 patients with bipolar I or bipolar II disorder or schizoaffective bipolar type confirmed by the Structured Clinical Interview for DSM-IV-TR disorders (SCID). Medical comorbidity burden was quantified utilizing the Cumulative Illness Severity Rating Scale (CIRS). This 13-item organ-based scale includes cardiac disease severity quantification. Confirmed by medical record review, patients who scored 1 (current mild or past significant problem) or higher in the cardiac item were compared by logistic regression to patients who scored 0 (no impairment), adjusting for CVD risk factors that were selected using a backwards stepwise approach or were obtained from the literature.

RESULTS:

In a multivariate model, age [odds ratio (OR) = 3.03, 95% confidence interval (CI): 1.66-5.54, p < 0.0001], hypertension (OR = 2.43, 95% CI: 1.69-3.55, p < 0.0001), and history of psychosis (OR = 1.48, 95% CI: 1.03-2.13, p = 0.03) were associated with CVD. When CVD risk factors from the literature were added to the analysis, age (OR = 3.19, 95% CI: 1.67-6.10, p = 0.0005) and hypertension (OR = 2.46, 95% CI: 1.61-3.76, p < 0.01) remained significant, with psychosis being at the trend level (OR = 1.43, 95% CI: 0.96-2.13, p = 0.08).

CONCLUSIONS:

The phenotype of psychotic bipolar disorder may reflect higher illness severity with associated cardiac comorbidity. Further studies are encouraged to clarify the effect of the disease burden (i.e., depression), lifestyle, and treatment interventions (i.e., atypical antipsychotics) on this risk association.

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

                       

11.       Ann Epidemiol. 2015 Jun;25(6):426-32. doi: 10.1016/j.annepidem.2015.03.014. Epub 2015 Mar 20.

Depressive symptoms are associated with incident coronary heart disease or revascularization among blacks but not among whites in the Reasons for Geographical and Racial Differences in Stroke study.

Sims M1, Redmond N2, Khodneva Y2, Durant RW3, Halanych J2, Safford MM2.

Author information:

•  1Department of Medicine, University of Mississippi Medical Center, Jackson, MS. Electronic address: msims2@umc.edu.

•  2Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.

•  3Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL; Birmingham Veterans Affairs Medical Center, Birmingham, AL.

Abstract

PURPOSE:

To examine the association of depressive symptoms with coronary heart disease (CHD) end points by race and income.

METHODS:

Study participants were blacks and whites (n = 24,443) without CHD at baseline from the national Reasons for Geographical and Racial Differences in Stroke cohort. Outcomes included acute CHD and CHD or revascularization. We estimated race-stratified multivariate Cox proportional hazards models of incident CHD and incident CHD or revascularization with the 4-item Center for Epidemiological Studies Depression Scale, adjusting for risk factors.

RESULTS:

Mean follow-up was 4.2 ± 1.5 years; CHD incidence was 8.3 events per 1000 person-years (n = 366) among blacks and 8.8 events per 1000 person-years (n = 613) among whites. After adjustment for age, sex, marital status, region, and socioeconomic status, depressive symptoms were significantly associated with incident CHD among blacks (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.00-1.91) but not among whites (HR, 1.10; 95% CI, 0.74-1.64). In the fully adjusted model, compared with blacks who reported no depressive symptoms, those reporting depressive symptoms had greater risk for the composite end point of CHD or revascularization (HR, 1.36; 95% CI, 1.01-1.81). Depressive symptoms were not associated with incident CHD end points among whites.

CONCLUSIONS:

High depressive symptoms were associated with higher risk of CHD or revascularization for blacks but not whites.

Copyright © 2015 Elsevier Inc. All rights reserved.

                       

12.       Atherosclerosis. 2015 Jun;240(2):529-34. doi: 10.1016/j.atherosclerosis.2015.04.800. Epub 2015 Apr 25.

Anxiety and depressive symptoms are associated with higher carotid intima-media thickness. Cross-sectional analysis from ELSA-Brasil baseline data.

Santos IS1, Goulart AC2, Brunoni AR2, Kemp AH3, Lotufo PA4, Bensenor IM4.

Author information:

•  1Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, Cerqueira César, São Paulo, Brazil. Electronic address: itamarss@usp.br.

•  2Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil.

•  3Centro de PesquisaClínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, AvenidaProf.LineuPrestes, 2565, CidadeUniversitária, São Paulo, Brazil; School of Psychology and Discipline of Psychiatry, University of Sydney, Griffith Taylor Building (A19), Sydney, NSW 2006, Australia.

•  4Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, Cerqueira César, São Paulo, Brazil.

Abstract

BACKGROUND:

Studies focusing on the association between anxiety/depressive symptoms and accelerated subclinical atherosclerosis have yielded mixed results. Our aim is to examine associations between anxiety/depressive symptoms, common mental disorder (CMD), major depression disorder (MDD) or generalized anxiety disorder (GAD) and carotid intima-media thickness (CIMT) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline.

METHODS:

The ELSA-Brasil baseline assessment included CIMT measurements and the Clinical Interview Schedule - Revised (CIS-R), a validated questionnaire for anxiety/depressive symptoms/diagnoses. We analyzed participants without previous coronary heart disease or stroke, and with high-quality CIMT images. We built regression models to determine whether the CIS-R score, CMD, MDD or GAD were associated with maximal CIMT levels.

RESULTS:

The study sample comprised 9744 participants. We found that individuals with higher CIS-R scores (Odds ratio for one standard deviation increase [OR]:1.12; 95% confidence interval [95%CI]:1.06-1.19), CMD (OR:1.22; 95%CI:1.07-1.38) and GAD (OR:1.19; 95%CI:1.01-1.41) had significantly higher odds of being classified in the highest age, sex and race-specific CIMT quartile. In the linear models, after adjustment for traditional cardiovascular risk factors, higher CIS-R scores (β:0.005; P = 0.010) and GAD (β:0.010; P = 0.049) were independently associated with CIMT values.

CONCLUSION:

Individuals with more symptoms of anxiety and/or depression, or diagnoses of CMD or GAD, had higher CIMT values, compared to peers of same age, sex and race. CIS-R scores and GAD were independently associated with higher CIMT values. These results suggest an association between anxiety/depressive symptoms (and, most notably, GAD) and accelerated subclinical atherosclerosis.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

           

13.       Br J Gen Pract. 2015 Jun;65(635):e401-8. doi: 10.3399/bjgp15X685309.

Understanding depression associated with chronic physical illness: a Q-methodology study in primary care.

Alderson SL1, Foy R1, House A1.

Author information:

•  1Institute of Health Sciences, University of Leeds, Leeds.

Abstract

BACKGROUND:

Detection of depression can be difficult in primary care, particularly when associated with chronic illness. Patient beliefs may affect detection and subsequent engagement with management. Q-methodology can help to identify viewpoints that are likely to influence either clinical practice or policy intervention.

AIM:

To identify socially shared viewpoints of comorbid depression, and characterise key overlaps and discrepancies.

DESIGN AND SETTING:

A Q-methodology study of patients registered with general practices or community clinics in Leeds, UK.

METHOD:

Patients with coronary heart disease or diabetes and depression from three practices and community clinics were invited to participate. Participants ranked 57 statements about comorbid depression. Factor analyses were undertaken to identify independent accounts, and additional interview data were used to support interpretation.

RESULTS:

Thirty-one patients participated; 13 (42%) had current symptoms of depression. Five accounts towards comorbid depression were identified: overwhelmed resources; something medical or within me; a shameful weakness; part of who I am; and recovery-orientated. The main differences in attitudes related to the cause of depression and its relationship with the patient's chronic illness, experience of shame, and whether medical interventions would help recovery.

CONCLUSION:

There are groups of patients who do not perceive a relationship between their depression and chronic illness; they may not understand the intention behind policy initiatives to identify depression during chronic illness reviews. Tailoring detection strategies for depression to take account of different clusters of attitudes and beliefs could help improve identification and personalise management.

© British Journal of General Practice 2015.

14.       Home Healthc Now. 2015 Jun;33(6):333-6. doi: 10.1097/NHH.0000000000000255.

Co-morbid Depression and Cardiovascular Disease in the Older Adult Homecare Patient.

Acee AM1.

Author information:

•  1Anna M. Acee, EdD, ANP-BC, PMHNP-BC, is an Associate Professor, Long Island University, Heilbrunn School of Nursing, Brooklyn, New York.

Abstract

Depression and cardiovascular disease are leading causes of morbidity and mortality in the United States and globally. Depression significantly increases the risk of fatal and nonfatal cardiovascular disease and increases the risk of mortality in patients with cardiovascular disease. Patients receiving home healthcare are disproportionally affected by depression. Comorbid depression can occur in two time frames: precardiac and postcardiac. It is imperative that home care patients be adequately screened and monitored for depressive symptoms. Home care patients with cardiac disease who are under treatment for depression should be carefully monitored for adherence to their medical care, drug efficacy, and safety with respect to their cardiovascular as well as mental health.

           

15.       Psychol Med. 2015 Jun 1:1-12. [Epub ahead of print]

Panic disorder and incident coronary heart disease: a systematic review and meta-regression in 1 131 612 persons and 58 111 cardiac events.

Tully PJ1, Turnbull DA1, Beltrame J2, Horowitz J2, Cosh S3, Baumeister H4, Wittert GA1.

Author information:

•  1Freemasons Foundation Centre for Men's Health,Discipline of Medicine,School of Medicine,The University of Adelaide,Australia.

•  2School of Medicine,Discipline of Medicine,The University of Adelaide,Australia.

•  3Clinic of Psychiatry and Psychotherapy II,University of Ulm,Gunzburg,Germany.

•  4Department of Rehabilitation Psychology and Psychotherapy,Institute of Psychology,University of Freiburg,Germany.

Abstract

BACKGROUND:

Substantial healthcare resources are devoted to panic disorder (PD) and coronary heart disease (CHD); however, the association between these conditions remains controversial. Our objective was to conduct a systematic review of studies assessing the association between PD, related syndromes, and incident CHD.

METHOD:

Relevant studies were retrieved from Medline, EMBASE, SCOPUS and PsycINFO without restrictions from inception to January 2015 supplemented with hand-searching. We included studies that reported hazard ratios (HR) or sufficient data to calculate the risk ratio and 95% confidence interval (CI) which were pooled using a random-effects model. Studies utilizing self-reported CHD were ineligible. Twelve studies were included comprising 1 131 612 persons and 58 111 incident CHD cases.

RESULTS:

PD was associated with the primary incident CHD endpoint [adjusted HR (aHR) 1.47, 95% CI 1.24-1.74, p < 0.00001] even after excluding angina (aHR 1.49, 95% CI 1.22-1.81, p < 0.00001). High to moderate quality evidence suggested an association with incident major adverse cardiac events (MACE; aHR 1.40, 95% CI 1.16-1.69, p = 0.0004) and myocardial infarction (aHR 1.36, 95% CI 1.12-1.66, p = 0.002). The risk for CHD was significant after excluding depression (aHR 1.64, 95% CI 1.45-1.85) and after depression adjustment (aHR 1.38, 95% CI 1.03-1.87). Age, sex, length of follow-up, socioeconomic status and diabetes were sources of heterogeneity in the primary endpoint.

CONCLUSIONS:

Meta-analysis showed that PD was independently associated with incident CHD, myocardial infarction and MACE; however, reverse causality cannot be ruled out and there was evidence of heterogeneity.

           

16.       World Psychiatry. 2015 Jun;14(2):119-36. doi: 10.1002/wps.20204.

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder.

Correll CU1,2,3,4, Detraux J5, De Lepeleire J6, De Hert M5.

Author information:

•  1Department of Psychiatry, Zucker Hillside Hospital, North Shore - Long Island Jewish Health System, Glen Oaks, New York, NY, USA.

•  2Department of Psychiatry and Molecular Medicine, Hofstra North Shore LIJ School of Medicine, Hempstead, New York, NY, USA.

•  3Psychiatric Neuroscience Center of Excellence, Feinstein Institute for Medical Research, Manhasset, New York, NY, USA.

•  4Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York, NY, USA.

•  5Department of Neurosciences, Catholic University Leuven, B-3070 Kortenberg, Belgium.

•  6Department of Public Health and Primary Care, University of Leuven, B-3000 Leuven, Belgium.

Abstract

People with severe mental illness have a considerably shorter lifespan than the general population. This excess mortality is mainly due to physical illness. Next to mental illness-related factors, unhealthy lifestyle, and disparities in health care access and utilization, psychotropic medications can contribute to the risk of physical morbidity and mortality. We systematically reviewed the effects of antipsychotics, antidepressants and mood stabilizers on physical health outcomes in people with schizophrenia, depression and bipolar disorder. Updating and expanding our prior systematic review publ




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JAMA Psychiatry. doi:10.1001/jamapsychiatry.2014.112 Published online April 30, 2014. [continua]


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