科研之友
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Background: Prior studies on the depression-heart disease association have not usually used diagnosticmeasures 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, togetherwith 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 disorderswas associated with heart disease in a dose-response fashion. Mood disorders and alcohol abusewere 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.
