Abstract
BackgroundThe relationship between neuroticism, depression and cardiovascular disease (CVD) is complex and has so far not been studied in depth. The aim of this study was to determine if neuroticism is an effect-modifier in the association between depression and CVD. Data derived from a longitudinal cohort study on mental health, work and relations among adults (20–64 years), including 10,443 individuals. Depression was assessed using the Major Depression Inventory (MDI) and neuroticism by the Swedish Scale of Personality (SSP). Outcomes of cardiovascular disease were register-based from the National inpatient register.ResultsBoth depression (OR 1.9 (95%CI 1.4, 2.5)) and high levels of neuroticism (OR 1.2 (95%CI 1.1–1.3)) were associated with increased risk of CVD. The combined effect of depression and neuroticism on the risk of CVD revealed HRs ranging from 1.0 to 1.9 after adjusting for age and gender, socioeconomic position, prevalent hypertension and diabetes. Almost similar associations were seen after further adjustment for lifestyle factors.ConclusionNeuroticism increased the risk of CVD in depressed persons. We found synergistic interaction between neuroticism and depression status in predicting future risk of CVD.
Highlights
The relationship between neuroticism, depression and cardiovascular disease (CVD) is complex and has so far not been studied in depth
High level of neuroticism was present in 27.7% (n = 2866) of the participants and of these persons 65.0% (n = 1862) were not depressed and 35.0% (n = 1004) were depressed
Depression was associated with an increased risk for CVD (OR 1.9 (95%CI 1.5,2.4) [20]
Summary
The relationship between neuroticism, depression and cardiovascular disease (CVD) is complex and has so far not been studied in depth. Persons with higher levels of neuroticism are often self-critical, sensitive to the criticism of others, and feel personally inadequate [3] This personality trait appears to be correlated with a wide range of mental and physical health problems [4] including. Almas et al BMC Cardiovascular Disorders (2017) 17:185 concluded that neuroticism was associated with a higher mortality risk in coronary heart disease but not in stroke [16]. These findings that were later confirmed in a pooled analysis from three cohort studies [6]. In the present study we use data from a longitudinal population-based Swedish cohort where depression has previously been shown to be associated with an increased risk for CVD (OR 1.9 (95%CI 1.4,2.5) [20]
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