title: Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression.
abstract: BACKGROUND
  Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, or taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown.
  
  
  METHODS
  Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician's diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset.
  
  
  RESULTS
  After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3-1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender.
  
  
  CONCLUSIONS
  Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology's links with heart disease onset has substantial clinical and public health implications.
authors.affiliation: Department of Psychological Medicine, University of Otago, Dunedin, New Zealand. Electronic address: kate.scott@otago.ac.nz.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Scott
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Liu
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Neill
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Silvia E
authors.initials: SE
authors.lastname: Florescu
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.forename: Nezar Ismet
authors.initials: NI
authors.lastname: Taib
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lépine
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.forename: Herbert
authors.initials: H
authors.lastname: Matschinger
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Medina-Mora
authors.forename: Marina
authors.initials: M
authors.lastname: Piazza
authors.forename: José A
authors.initials: JA
authors.lastname: Posada-Villa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Uda
authors.forename: Bogdan J
authors.initials: BJ
authors.lastname: Wojtyniak
authors.forename: Carmen C W
authors.initials: CC
authors.lastname: Lim
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D003986:Dibenzocycloheptenes; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology; D010698:Phobic Disorders / Q000453:epidemiology; D011237:Predictive Value of Tests; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003986:Dibenzocycloheptenes; C011597:amineptin
keywords: Alcohol abuse; Anxiety disorders; Comorbidity; Depression; Heart disease