Mental disorders and general well-being in cardiology outpatients--6-year survival.
OBJECTIVE
Long-term survival in a sample of cardiology outpatients with and without mental disorders and other psychosocial risk factors.


METHODS
In a cardiology outpatient setting, 103 consecutive patients were asked to participate in the study. Of these, 86 were included and screened for mental disorder with the Primary Care Evaluation of Mental Disorders; Structured Clinical Interview for DSM-III-R, Non-Patient Edition, psychosis screening; the Clock Drawing Test; and the WHO-5 Well-Being Index. The cardiologists were asked in each patient to rate the severity of somatic disease and mental problems on visual analogue scales (VAS-somatic and VAS-mental). Cardiac diagnosis, noncardiac comorbidity, history of mental disorder, and the number of daily social contacts were noted. Survival was followed for 6 years.


RESULTS
At baseline, 33 (38.4%) patients had mental disorder, 6 dementia, 11 major depression, 6 minor depression, 6 anxiety disorder, 2 unspecified somatoform disorder, 1 alcohol abuse, and 1 psychosis. At 6 years of follow-up, 40 (47%) patients were deceased, 17 (48%) of those with and 23 (46%) of those without mental disorder. In a survival analysis, mortality was significantly predicted by age [hazard ratio (HR), 1.058], WHO-5 (HR, 0.977), the number of social contacts (HR, 0.699), VAS-somatic (HR, 1.016), and cardiac diagnosis (HR, 0.333).


CONCLUSIONS
In chronic heart disease, well-being and social support seem related to long-term survival.
Birket-Smith
Morten
M
Liaison Psychiatry Research Unit, Psychiatric Centre Bispebjerg, Copenhagen NV, Denmark. mbs01@bbh.regionh.dk
Hansen
Baiba H
BH
Hanash
Jamal A
JA
Hansen
Jørgen F
JF
Rasmussen
Alice
A
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D002908:Chronic Disease; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D015996:Survival Rate