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

Kinley, Jolene; Lowry, Helen; Katz, Cara; Jacobi, Frank; Jassal, Davinder S.; Sareen, Jitender

doi:10.1016/j.genhosppsych.2015.03.022

Cited by 32 publications

(35 citation statements)

References 37 publications

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“…Anxious individuals tend to have increased dietary cholesterol intake, elevated total energy intake, sedentary lifestyle, and decreased physical activity [46], consistent with the finding that patients with PD and GAD have increased odds of dyslipidemia, obesity, diabetes, and substance use [47, 48]. Patients with PTSD have poor diet quality (with most energy obtained from fatty acids), decreased physical activity, increased obesity, and increased rates of smoking [49].…”

Section: Mechanisms Mediating the Relationships Between Anxiety Disormentioning

confidence: 68%

Anxiety Disorders and Cardiovascular Disease

Celano

Daunis

Lokko

et al. 2016

Curr Psychiatry Rep

278

173

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Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been linked to adverse cardiovascular outcomes, including mortality. Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease. Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Fortunately, pharmacologic and psychotherapeutic interventions for the management of anxiety disorders are generally safe and effective. Further study is needed to determine whether interventions to treat anxiety disorders ultimately impact both psychiatric and cardiovascular health.

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Section: Mechanisms Mediating the Relationships Between Anxiety Disormentioning

confidence: 68%

Anxiety Disorders and Cardiovascular Disease

Celano

Daunis

Lokko

et al. 2016

Curr Psychiatry Rep

278

173

View full text Add to dashboard Cite

show abstract

“…Third, all physical conditions were past-year and based on self-report. Although this study examined self-reported physical conditions based on physician diagnoses, there may be reporting bias; however, studies have shown good reliability of self-report as compared to physical health measures (Baumeister et al, 2010; Edwards et al, 1996; Kinley et al, 2012). Fourth, the NESARC does not include a measure of past-year chronic pain, which is an important potential pathway in the relationships described here.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for incident nonmedical prescription opioid use and abuse and dependence: Results from a longitudinal nationally representative sample

Katz¹,

El‐Gabalawy²,

Keyes³

et al. 2013

Drug and Alcohol Dependence

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111

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Background There has been a significant increase in opioid prescriptions and the prevalence of opioid nonmedical use. Nonmedical use may lead to opioid abuse/dependence, a serious public health concern. The aim of this paper was to determine the mental and physical health predictors of incident nonmedical prescription opioid use (NMPOU) and abuse/dependence, and the impact of comorbidity in a longitudinal, nationally representative sample. Methods Data come from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653; ≥20 years old). Mental disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV edition. Physical conditions were based on self-reports of physician-diagnoses. Multiple logistic regression models examined the associations between mental and physical health predictors at Wave 1 and their association to incident NMPOU and abuse/dependence disorders at Wave 2. Results After adjusting for sociodemographics, Axis I and II mental disorders and physical conditions, the presence of mental disorders (i.e., mood, personality disorders and substance use disorders), physical conditions (i.e., increasing number of physical conditions, any physical condition, arteriosclerosis or hypertension, cardiovascular disease and arthritis) and sociodemographic factors (i.e., sex and marital status) at Wave 1 positively predicted incident abuse/dependence at Wave 2. Comorbid disorders increased the risk of NMPOU and abuse/dependence. Conclusion These results suggest the importance of mental and physical comorbidity as a risk for NMPOU and abuse/dependence, emphasizing the need for careful screening practices when prescribing opioids.

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“…3,4 There is a growing concern based on longitudinal evidence that the consequences of some adolescent emergent major depression episodes include suicide, persistent and chronic mental health disorders, substance misuse, and failure to achieve both educationally and in the work place. 5 Furthermore, in adults there is evidence that a history of depression may interfere with treatment compliance and self-care in patients with type 2 diabetes and cardiovascular disease, 6 which suggests that reducing incident risk for depression early in life may have wider physical health-care benefits for later in the life course. These medium-and long-term negative outcomes also come at great economic cost to the UK and other nations, including in the developing world where depression has been noted to be at least as disabling as any other chronic illness in adult life as urbanisation increases.…”

Section: Unipolar Major Depression In Adolescentsmentioning

confidence: 99%

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

Goodyer

Reynolds

Barrett

et al. 2017

Health Technol Assess

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BackgroundAlthough there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years.ObjectiveTo determine whether or not either of two specialist psychological treatments, cognitive–behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment.DesignObserver-blind, parallel-group, pragmatic superiority randomised controlled trial.SettingA total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London.ParticipantsAdolescents aged 11–17 years withDiagnostic and Statistical Manual of Mental Disorders-Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses.InterventionsIn total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up.Main outcome measuresMean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation.ResultsThere were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up = –0.578, 95% confidence interval (CI) –2.948 to 4.104;p = 0.748]. There were no superiority effects for the two specialist treatments (CBT + STPP) compared with BPI (treatment effect by final follow-up = –1.898, 95% CI –4.922 to 1.126;p = 0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49–52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome.ConclusionsThe three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings.LimitationsNeither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data.Trial registrationCurrent Controlled Trials ISRCTN83033550.FundingThis project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit toThe Lancet.

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

Cited by 32 publications

References 37 publications

Anxiety Disorders and Cardiovascular Disease

Anxiety Disorders and Cardiovascular Disease

Risk factors for incident nonmedical prescription opioid use and abuse and dependence: Results from a longitudinal nationally representative sample

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

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