title: Global Psychological Distress and Risk of Atrial Fibrillation Among Women: The Women's Health Study.
abstract: BACKGROUND
  Symptoms of psychological distress and depression have been associated with risk of ventricular arrhythmias and sudden cardiac death. Their relationship with atrial arrhythmias, however, is less well studied.
  
  
  RESULTS
  We sought to assess the long-term relations between psychological distress and risk of atrial fibrillation (AF) in the Women's Health Study of female health professionals. We measured psychological symptoms with the Mental Health Inventory-5. Incident AF was assessed annually and verified through medical records. Among 30 746 women without history of cardiovascular disease or AF, 771 cases of AF occurred during a median follow-up of 125 months (interquartile range, 117-130 months). Global psychological distress was not associated with AF risk in age-stratified (P=0.61 for linear trend) or multivariable proportional-hazards models that included antidepressant use (P=0.34). A proxy measure for depression, consisting of Mental Health Inventory-5 score <53, antidepressant use, or both, was also not associated with AF risk in multivariable models (hazard ratio=0.99; 95% confidence interval, 0.78-1.25; P=0.93). In post hoc analyses of individual symptoms from the Mental Health Inventory-5, positive affect, "feeling happy some/a good bit of the time," was associated with reduced risk of AF (hazard ratio=0.69; 95% confidence interval, 0.49-0.99; P=0.04); other depressive and anxious symptoms were not.
  
  
  CONCLUSIONS
  In this prospective study of women without known cardiovascular disease, global psychological distress and specific depressive symptoms were unrelated to AF risk. (J Am Heart Assoc. 2012;1:e001107 doi: 10.1161/JAHA.112.001107.).
authors.affiliation: Department of Medicine, Columbia University Medical Center,  New York, NY (W.W., K.W.D.).
authors.forename: William
authors.initials: W
authors.lastname: Whang
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: David
authors.initials: D
authors.lastname: Conen
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Everett
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
keywords: arrhythmia; atrial fibrillation; epidemiology; women