title: Mental disorders among persons with heart disease - results from World Mental Health surveys.
abstract: 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.
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands. j.ormel@med.umcg.nl
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Huibert
authors.initials: H
authors.lastname: Burger
authors.forename: Kate
authors.initials: K
authors.lastname: Scott
authors.forename: Koen
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: Yue-qin
authors.initials: YQ
authors.lastname: Huang
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Jean
authors.initials: J
authors.lastname: Pierre Lepine
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.forename: Elie
authors.initials: E
authors.lastname: Karam
authors.forename: María Elena
authors.initials: ME
authors.lastname: Medina-Mora
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.forename: David
authors.initials: D
authors.lastname: Williams
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Ron
authors.initials: R
authors.lastname: Kessler
mesh_terms: 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