Mental disorders among persons with heart disease - results from World Mental Health surveys.
OBJECTIVE
While depression and heart disease often co-occur in Western countries, less is known about the association of anxiety and alcohol use disorders with heart disease and about the cross-cultural consistency of this association. Consistency across emotional disorders and cultures would suggest that relatively universal mechanisms underlie the association.


METHODS
Surveys with 18 random population samples of household-residing adults in 17 countries in Europe, the Americas, the Middle East, Africa, Asia and the South Pacific were carried out. Medically recognized heart disease was ascertained by self-report. Mental disorders were assessed with the World Mental Health Composite International Diagnostic Interview, a fully structured diagnostic interview.


RESULTS
Specific mood and anxiety disorders occurred among persons with heart disease at rates higher than those among persons without heart disease. Adjusted for sex and age, the pooled odds ratios (95% confidence interval) were 2.1 (1.9-2.5) for mood disorders, 2.2 (1.9-2.5) for anxiety disorders and 1.4 (1.0-1.9) for alcohol abuse/dependence among persons with versus those without heart disease. These patterns were similar across countries.


CONCLUSIONS
An excess of anxiety disorders and that of mood disorders are found among persons with heart disease. These associations hold true across countries despite substantial between-country differences in culture and mental disorder prevalence rates. These results suggest that similar mechanisms underlie the association and that a broad spectrum of mood-anxiety disorders should be considered in research on the comorbidity of mental disorders and heart disease.
Ormel
Johan
J
Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands. j.ormel@med.umcg.nl
Von Korff
Michael
M
Burger
Huibert
H
Scott
Kate
K
Demyttenaere
Koen
K
Huang
Yue-qin
YQ
Posada-Villa
José
J
Pierre Lepine
Jean
J
Angermeyer
Matthias C
MC
Levinson
Daphna
D
de Girolamo
Giovanni
G
Kawakami
Norito
N
Karam
Elie
E
Medina-Mora
María Elena
ME
Gureje
Oye
O
Williams
David
D
Haro
Josep Maria
JM
Bromet
Evelyn J
EJ
Alonso
Jordi
J
Kessler
Ron
R
D000328:Adult; D015897:Comorbidity; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000453:epidemiology