Psychiatric disorders in hypertrophic cardiomyopathy.
OBJECTIVE
Depression is undertreated in cardiac disease. Our aim was to evaluate frequency and risk factors of psychiatric disorders in hypertrophic cardiomyopathy.


METHODS
This was a two-phase epidemiological approach, using screening questionnaire then gold standard structured clinical interview. A cohort of 148 patients aged > or =18 (78% response rate) attending a dedicated hypertrophic cardiomyopathy clinic (1996-1998) were screened for psychiatric morbidity using Hospital Anxiety and Depression Scale and Social Adjustment Scale. Likely cases and noncases were evaluated by Structured Clinical Interview for DSM-III-R. The main outcome measure was prevalence of psychiatric diagnoses, with descriptive comparison against population statistics.


RESULTS
Thirty-seven percent of cardiomyopathy patients fulfilled criteria for anxiety disorder and 21% for mood disorder. Presence of mood disorder was associated with chest pain [relative risk (RR) 4.5, 95% CI 2.8-17.5], older age (2.8, 1.4-5.6), higher perceived risk of death (5.4, 2.3-13.0), poorer social adjustment (2.1, 1.1-4.2) and problems with sexual relations (1.5, 1.2-3.6). Presence of anxiety disorders was associated with chest pain (RR 3.5, 95% CI 2.1-26.0), higher perceived risk of death (2.0, 1.2-3.4), perception of physical symptoms as 'severe' (2.2, 1.2-4.2) and more recent diagnosis (1.7, 1.0-2.7).


CONCLUSIONS
Patients with cardiomyopathy have an elevated risk of mood disorders and anxiety disorders. Several demographic and clinical factors were found to be associated with these psychiatric conditions. Proper treatment intervention is likely to improve quality of life.
Morgan
John F
JF
Department of Psychiatry, Yorkshire Centre for Eating Disorders, Seacroft Hospital, LS14 6UH LEEDS, UK. john.morgan@leedsmh.nhs.uk <john.morgan@leedsmh.nhs.uk>
O'Donoghue
Ann C
AC
McKenna
William J
WJ
Schmidt
Martin M
MM
D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology