The high prevalence of multiple psychiatric disorders in stable outpatients with coronary heart disease.
OBJECTIVE
There is accumulating evidence of high prevalence of comorbid psychiatric disorders in patients with coronary heart disease (CHD). However, most of these studies focused on one psychiatric disorder or one set of psychological symptoms and detected psychiatric disorders in acutely ill CHD patients. To date, no systematic comprehensive psychiatric diagnostic evaluation has been performed in a consecutive sample of stable CHD outpatients.


METHODS
One hundred stable CHD outpatients of the Cardiology Division outpatient clinic at the Massachusetts General Hospital were included in the study. Psychiatric diagnoses were established by using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (axes I-V).


RESULTS
Frequent comorbid psychiatric diagnoses were detected, including single past major depressive episode (29%), current dysthymic disorder (15%), recurrent major depressive disorder with current major depressive episode (31%), current alcohol abuse (19%), posttraumatic stress disorder (29%), current generalized anxiety disorder (24%), current binge-eating disorder (10%), and current primary insomnia (13%). The mean number of comorbid clinical psychiatric disorders per subject was 1.7.


CONCLUSIONS
The findings suggest high prevalence rates of comorbid psychiatric disorders as well as a broad spectrum of psychiatric disorders in stable CHD outpatients. However, larger epidemiological studies are needed in order to determine the true prevalence of these disorders in CHD patients.
Bankier
Bettina
B
Behavioral Medicine Division of Preventive Cardiology, Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, 50 Staniford Street, Suite 401, Boston, MA 02114, USA. bbankier@partners.org
Januzzi
James L
JL
Littman
Andrew B
AB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology