Controlled direct effect of psychiatric disorders on cardiovascular disease: evidence from a large Kurdish cohort

Abstract

Background Psychiatric disorders are significantly associated with the incidence and prevalence of cardiovascular diseases, mortality, hospital readmissionn. Oral and dental hygiene may play a role in such association. This study aimed to evaluate the controlled direct effect of psychiatric disorders on cardiovascular diseases by controlling the mediating effect of oral and dental hygiene. Methods The data used for this study came from the baseline phase of Ravansar Non-communicable Disease (RaNCD) cohort study. RaNCD cohort study is including a representative sample of 10,065 adults (35–65 years old) living in Ravansar, a city in the west of Iran. The marginal structural model with stabilized inverse probability weights accounted for potential confounders was used to estimate the controlled direct effect of psychiatric disorders on cardiovascular diseases. Three different models using three mediators including oral and dental hygiene behaviors, oral ulcer and lesions, and decayed, missing, and filled tooth, were used. Results Psychiatric disorders increase the odds of cardiovascular diseases by 83% (OR = 1.83, CI 1.27, 2.61) and about two times (OR = 2.14, 95% CI 1.74, 2.63) when controlled for oral and dental hygiene behaviors, and oral ulcer and lesions as mediators, respectively. When decayed, missing, and filled tooth, as a mediator, was set at ≤ 8, there was no statistically significant controlled direct effect of psychiatric disorders on cardiovascular diseases (OR = 0.90, 95% CI 0.62, 1.30). Conclusion Our results suggested that psychiatric disorder was directly related to cardiovascular diseases even if it was possible to have good oral and dental hygiene. The results suggested that interventions targeting people with psychiatric disorders could reduce prevalence of the cardiovascular diseases.

A Mendelian randomization study of the effect of mental disorders on cardiovascular disease

“…With the development of the biopsychosocial model, more and more researchers have found a close link between psychological factors and CVD (21). Studies have shown that MD may be an independent risk factor for CVD (22). They increase the morbidity and mortality of CVD patients and reduce the quality of survival in CVD patients (22,23).…”

“…Studies have shown that MD may be an independent risk factor for CVD ( 22 ). They increase the morbidity and mortality of CVD patients and reduce the quality of survival in CVD patients ( 22 , 23 ).…”

The Causal Effects of Anxiety-Mediated Social Support on Death in Patients with Chronic Heart Failure: A Multicenter Cohort Study

“…This analysis and research method has the same idea as many other articles, which can ensure the reliability of the research results. [16][17][18] From the perspective of social medicine and social psychology, prolonged chronic diseases may break the life balance of individuals. When the coping mechanism is ineffective, individuals live with depression, anxiety, sleep disorders, and other symptoms.…”

Strict association between development of psychological conditions and hypertension incidence: A cross‐sectional study

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“… 5 On the other hand, a growing body of evidence has emphasized the substantial role of psychological disorders, especially depressive disorder, anxiety states, including panic disorder, post‐traumatic psychological symptoms, and mental stress in the development of CVDs. 6 , 7 , 8 To some extent, poor outcomes of patients with CVDs and concomitant psychological disorders have made them the subjects of much recent research in this era. 9 , 10 Depression in patients with congestive heart failure (CHF) has an independent prognostic role in patients' outcomes and can promote about two to three‐fold higher rates of re‐hospitalization and mortality.…”