Higher comorbidity of depression and cardiovascular disease in women: a biopsychosocial perspective.
OBJECTIVE
The present paper aims at offering a synthesis of possible reasons of the higher comorbidity of cardiovascular disease (CVD) and depression in women from a biopsychosocial perspective.


METHODS
The available literature is reviewed under sex/gender aspects related to the link between depression and CVD and common pathways to depression and CVD associated with chronic stress experiences including pathophysiological mechanisms and behavioural, cognitive, psychosocial and sociological risk factors/predictors.


RESULTS
There is considerable evidence that greater exposure to chronic stressors in women, interpersonal stress responsiveness, and internalizing coping styles are associated with an elevated risk of CVD and/or depression through behavioural and pathophysiological mechanisms including alterations in HPA axis functioning and autonomic nervous system which appear to be specific for women.


CONCLUSIONS
Women seem to be more strongly affected by psychosocial stressors related to CVD and depression as well as by direct and indirect effects of chronic stress compared to men. More evidence in understanding these differences within the biological, psychosocial and sociostructural determinants and pathways is essential for promoting women's health.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany. Anne-Maria.Moeller-Leimkuehler@med.uni-muenchen.de
Anne Maria
AM
Möller-Leimkühler
D000223:Adaptation, Psychological / Q000502:physiology; D052636:Allostasis / Q000502:physiology; D001143:Arousal / Q000502:physiology; D001341:Autonomic Nervous System / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005783:Gender Identity; D012739:Gonadal Steroid Hormones / Q000502:physiology; D015438:Health Behavior; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood; D007389:Internal-External Control; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology / Q000523:psychology
D012739:Gonadal Steroid Hormones; D018836:Inflammation Mediators