Severity of Depression, Anxious Distress and the Risk of Cardiovascular Disease in a Swedish Population-Based Cohort.

Aysha Almas,Romaina Iqbal,Yvonne Forsell,Jette Moller,Imre Janszky

doi:10.1371/journal.pone.0140742

Aysha Almas, Romaina Iqbal + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0140742

Copy DOI

Abstract

BackgroundDepression is known to be associated with cardiovascular diseases (CVD). This population-based cohort study aimed to determine the association between depression of varying severity and risk for CVD and to study the effect of concomitant anxious distress on this association.MethodsWe utilized data from a longitudinal cohort study of mental health, work and relations among adults (20–64 years), with a total of 10,443 individuals. Depression and anxious distress were assessed using psychiatric rating scales and defined according to DSM-5. Outcomes were register-based and self-reported cardiovascular diseases.FindingsOverall increased odds ratios of 1.5 to 2.6 were seen for the different severity levels of depression, with the highest adjusted OR for moderate depression (OR 2.1 (95% CI 1.3, 3.5). Similar odds ratios were seen for sub-groups of CVD: ischemic/hypertensive heart disease and stroke, 2.4 (95% CI 1.4, 3.9) and OR 2.1 (95%CI 1.2, 3.8) respectively. Depression with anxious distress as a specifier of severity showed OR of 2.1 (95% CI 1.5, 2.9) for CVD.ConclusionThis study found that severity level of depression seems to be of significance for increased risk of CVD among depressed persons, although not in a dose-response manner which might be obscured due to treatment of depression. Further, we found a higher risk of CVD among depressed individuals with symptoms of anxious distress.

Highlights

Depression is a large and increasing public health problem, and the majority of cases are not detected in health care.[1]
This study found that severity level of depression seems to be of significance for increased risk of cardiovascular diseases (CVD) among depressed persons, not in a dose-response manner which might be obscured due to treatment of depression
We found a higher risk of CVD among depressed individuals with symptoms of anxious distress

Summary

Introduction

Depression is a large and increasing public health problem, and the majority of cases are not detected in health care.[1]. The dose-response relationship between depression and future risk of CVD has not been well studied. There is are two studies that report incremental increase in the risk of future CVD with increasing severity of depression. Both studies are based on patients from hospital or clinic setting.[14,15]. Depression is known to be associated with cardiovascular diseases (CVD). This population-based cohort study aimed to determine the association between depression of varying severity and risk for CVD and to study the effect of concomitant anxious distress on this association

Results

Discussion

Conclusion