Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States

Armbrecht, Eric S.; Shah, Anuj; Schepman, Patricia; Shah, Ruchit; Pappadopulos, Elizabeth; Chambers, Richard; Stephens, Jennifer; Haider, Seema; McIntyre, Roger S.

doi:10.1080/13696998.2020.1776297

Cited by 28 publications

(25 citation statements)

References 46 publications

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“…The heart–brain axis shows close interaction, as depression and anxiety are related to a higher risk of CV events and mortality [ 118 , 119 , 120 , 121 , 122 ]. Nevertheless, in this COVID-19 period, psychological load does not seem associated with CV disease exacerbation, but rather with a fall in hospital admissions.…”

Section: Discussionmentioning

confidence: 99%

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

Gorini

Chatzianagnostou

Mazzone

et al. 2020

IJERPH

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Coronavirus disease 2019 (COVID-19) has quickly become a worldwide health crisis.Although respiratory disease remains the main cause of morbidity and mortality in COVID patients,myocardial damage is a common finding. Many possible biological pathways may explain therelationship between COVID-19 and acute myocardial infarction (AMI). Increased immune andinflammatory responses, and procoagulant profile have characterized COVID patients. All theseresponses may induce endothelial dysfunction, myocardial injury, plaque instability, and AMI.Disease severity and mortality are increased by cardiovascular comorbidities. Moreover, COVID-19has been associated with air pollution, which may also represent an AMI risk factor. Nonetheless,a significant reduction in patient admissions following containment initiatives has been observed,including for AMI. The reasons for this phenomenon are largely unknown, although a real decreasein the incidence of cardiac events seems highly improbable. Instead, patients likely may presentdelayed time from symptoms onset and subsequent referral to emergency departments because offear of possible in-hospital infection, and as such, may present more complications. Here, we aim todiscuss available evidence about all these factors in the complex relationship between COVID-19and AMI, with particular focus on psychological distress and the need to increase awareness ofischemic symptoms.

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Section: Discussionmentioning

confidence: 99%

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

Gorini

Chatzianagnostou

Mazzone

et al. 2020

IJERPH

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“…One key factor that frequently complicates the diagnosis of depression is comorbid chronic pain, as patients presenting with pain are more likely to be investigated medically rather than as part of a broader biopsychosocial framework (3). Depression and chronic pain frequently coexist, with up to 60% of chronic pain patients also presenting with depression (4,5). Furthermore, the combination of chronic pain and depression leads to poorer treatment outcomes and overall functioning than either condition alone (6).…”

Section: Introductionmentioning

confidence: 99%

Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness

et al. 2021

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The bidirectional relationship between depression and chronic pain is well-recognized, but their clinical management remains challenging. Here we characterize the shared risk factors and outcomes for their comorbidity in the Australian Genetics of Depression cohort study (N = 13,839). Participants completed online questionnaires about chronic pain, psychiatric symptoms, comorbidities, treatment response and general health. Logistic regression models were used to examine the relationship between chronic pain and clinical and demographic factors. Cumulative linked logistic regressions assessed the effect of chronic pain on treatment response for 10 different antidepressants. Chronic pain was associated with an increased risk of depression (OR = 1.86 [1.37–2.54]), recent suicide attempt (OR = 1.88 [1.14–3.09]), higher use of tobacco (OR = 1.05 [1.02–1.09]) and misuse of painkillers (e.g., opioids; OR = 1.31 [1.06–1.62]). Participants with comorbid chronic pain and depression reported fewer functional benefits from antidepressant use and lower benefits from sertraline (OR = 0.75 [0.68–0.83]), escitalopram (OR = 0.75 [0.67–0.85]) and venlafaxine (OR = 0.78 [0.68–0.88]) when compared to participants without chronic pain. Furthermore, participants taking sertraline (OR = 0.45 [0.30–0.67]), escitalopram (OR = 0.45 [0.27–0.74]) and citalopram (OR = 0.32 [0.15–0.67]) specifically for chronic pain (among other indications) reported lower benefits compared to other participants taking these same medications but not for chronic pain. These findings reveal novel insights into the complex relationship between chronic pain and depression. Treatment response analyses indicate differential effectiveness between particular antidepressants and poorer functional outcomes for these comorbid conditions. Further examination is warranted in targeted interventional clinical trials, which also include neuroimaging genetics and pharmacogenomics protocols. This work will advance the delineation of disease risk indicators and novel aetiological pathways for therapeutic intervention in comorbid pain and depression as well as other psychiatric comorbidities.

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“…Mental disorders are both upstream and downstream of “physical” illness—diagnosable depression and anxiety—and subclinical and subthreshold variants that may otherwise escape detection [ 43 ]—are linked to subsequent cardiovascular disease (CVD) and other NCDs and are also noted sequalae of most NCDs [ 44 ]. Indeed, comorbidity research shows 60% of patients with anxiety or major depressive disorder have one or more chronic NCD [ 45 ]. Thus, concepts of “no health without mental health” should sit at the heart of the mission of ARPA-H.…”

Section: The Risk Of Limiting the Scope And Impact Of Arpa-h Before It Beginsmentioning

confidence: 99%

Earth Dreams: Reimagining ARPA for Health of People, Places and Planet

Logan¹,

Berman

Prescott

2021

IJERPH

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Bold new approaches are urgently needed to overcome global health challenges. The proposed Advanced Research Projects Agency for Health (ARPA-H) is intended to provide rapid health breakthroughs. While new technologies for earlier disease detection and more effective treatment are critical, we urge equal attention be given to the wider (physical, emotional, social, political, and economic) environmental ecosystems driving the non-communicable disease (NCD) crisis in the first place. This requires an integrated, cross-sectoral vision that spans the interwoven connections affecting health across the scales of people, places, and planet. This wider “exposome” perspective considers biopsychosocial factors that promote resilience and reduce vulnerabilities of individuals and communities over time—the many variables driving health disparities. Since life course health is strongly determined by early life environments, early interventions should be prioritized as a matter of effectiveness and social justice. Here, we explore the origins of the Advanced Research Project Agency and point to its potential to build integrated solutions, with wisdom and ethical value systems as a compass. Since the planned ARPA-H is anticipated to spawn international collaborations, the imagined concept is of relevance to a broad audience of researchers. With appropriate input, the quest for health equity through personalized, precision medicine while deconstructing unacceptable structural inequities may be accelerated.

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Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States

Cited by 28 publications

References 46 publications

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness

Earth Dreams: Reimagining ARPA for Health of People, Places and Planet

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