The Head Stands Accused by the Heart! —Depression and Premature Death from Ischaemic Heart Disease

Wendy Thomson

University of Bristol, School of Experimental Psychology, Bristol, UK.

DOI: 10.4236/ojd.2014.32008                

Abstract

Background: The purpose of this study was to examine whether clinical depression was associated with higher risk of premature death from ischemic heart disease (IHD). Risk for IHD was examined separately by sex and sub-type of depression in a long-term follow-up study spanning 49 years. Method: Patients who were diagnosed with depression in the Chichester/Salisbury Catchment Area Study were followed for 49 years. Observed deaths from IHD prior to the age of 70 were compared with rates that were predicted from historical data on mortality rates from 1960 onwards. Results: Significantly higher rates of death from IHD before the age of 70 were found among males with endogenous depression. Conclusions: The results are discussed in terms of the broader literature on mortality from natural causes among patients with clinical depression. In terms of prevention, the results indicate that patients diagnosed with severe clinical depression particularly men at the very least warrant risk assessment with regard to IHD.

Keywords

Severe Clinical Depression, Ischemic Heart Disease, Mortality, Longitudinal Study, Prospective, Sex Differences, Risk Assessment

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Allender, S., Scarborough, P., O’Flaherty, M., & Capewell, S. (2008). Patterns of Coronary Heart Disease Mortality over the 20th Century: Possible Plateaus in the Rate of Decline. BMC Public Health, 8, 148-160. http://dx.doi.org/10.1186/1471-2458-8-148
[2]	Angst, F., Stassen, H. H., Clayton, P. J., & Angst, J. (2002). Mortality of Patients with Mood Disorders: Follow-Up over 34 to 38 Years. Journal of Affective Disorders, 68, 167-181. http://dx.doi.org/10.1016/S0165-0327(01)00377-9
[3]	Aromaa, A., Raitasalo, R., Reunanen, A, Impivaara, O., Heiovaara, M., Knect, P., Lehtinen, V., Joukamaa, M., & Naatreka, J. (1994). Depression and Cardiovascular Diseases. Acta Psychiatrica Scandinavica, 377, 77-82. http://dx.doi.org/10.1111/j.1600-0447.1994.tb05807.x
[4]	Bruce, M. L., Leaf, P. J., Rozal, G. P., Florio, L., & Hoff, R. A. (1994). Psychiatric Status and 9-Year Mortality Data in the New Haven Epidemiologic Catchment Area Study. American Journal of Psychiatry, 151, 716-721.
[5]	Coryell, W., Noyes, R., & Clancy, J. (1982). Excess Mortality in Panic Disorders. Archives of General Psychiatry, 39, 701-703. http://dx.doi.org/10.1001/archpsyc.1982.04290060051010
[6]	Haugland, G., Craig, T. J., Goodman, A. B., & Siegel, C. (1983). Mortality in the Era of Deinstitutionalization. American Journal of Psychiatry, 136, 848-852.
[7]	Hoyer, E. H., Mortensen, P. B., & Olesen, A. W. (2000). Mortality and Causes of Death in a Total National Sample of Patients with Affective Disorders Admitted for the First Time between 1973 and 1993. British Journal of Psychiatry, 176, 76-82. http://dx.doi.org/10.1192/bjp.176.1.76
[8]	Kouzis, A., Eaton, W. W., & Leaf, P. J. (1995). Psychopathology and Mortality in the General Population. Social Psychiatry and Psychiatric Epidemiology, 30, 175-70. http://dx.doi.org/10.1007/BF00790655
[9]	Kreitman, N., Sainsbury, P., Morriset, J., Towers, J., & Scrivener, J. (1961). The Reliability of Psychiatric Assessment: An Analysis. Journal of Mental Science, 107, 887-908.
[10]	Lawrence, D. M., Holman, C. D., Jablensky, A. V., & Hobbs, M. S. (2003). Death Rate from Ischaemic Heart Disease in Western Australian Psychiatric Patients 1980-1998. British Journal of Psychiatry, 182, 31-36. http://dx.doi.org/10.1192/bjp.182.1.31
[11]	Murphy, J., Monson, R. R., Oliver, D. C., & Leighton, A. H. (1987). Affective Disorders and Mortality. Archives of General Psychiatry, 44, 473-80. http://dx.doi.org/10.1001/archpsyc.1987.01800170095012
[12]	Mykletun, A., Bjerkeset, O., ?verland, S., Prince, M., Dewey, M., & Stewart, R. (2009). Levels of Anxiety and Depression as Predictors of Mortality: The HUNT Study. British Journal of Psychiatry, 195, 118-125. http://dx.doi.org/10.1192/bjp.bp.108.054866
[13]	Nicholson, A., Kuper, H., & Hemingway, H. (2006). Depression as an Aetiolgic and Prognostic Factor in Coronary Heart Disease: A Meta-Analysis of 6362 Events among 146538 Participants in 54 Observational Studies. European Heart Journal, 27, 2763-2774. http://dx.doi.org/10.1093/eurheartj/ehl338
[14]	Osby, U., Brandt, L., Correia, N., Ekborn, A., & Sparen, P. (2011). Excess Mortality in Bipolar and Unipolar Disorder in Sweden. Archives of General Psychiatry, 58, 844-850. http://dx.doi.org/10.1001/archpsyc.58.9.844
[15]	Pratt, L. A., Ford, D. E., Crum, R. M., Armenian, H. K., Gallo, J. J., & Eaton, W. W. (1996). Depression, Psychotropic Medication, and Risk of Myocardial Infarction. Circulation, 94, 3123-3129. http://dx.doi.org/10.1161/01.CIR.94.12.3123
[16]	Rorsman, B. (2007). Mortality among Psychiatric Patients. Acta Psychiatrica Scandinavica, 50, 354-375. http://dx.doi.org/10.1111/j.1600-0447.1974.tb08221.x
[17]	Rosner, B. R. (2005). Fundamentals of Biostatistics. New York: Brooks Cole.
[18]	Rugulies, R. (2002). Depression as a Predictor for Coronary Heart Disease: A Review and Meta-Analysis. American Journal of Preventative Medicine, 23, 51-61. http://dx.doi.org/10.1016/S0749-3797(02)00439-7
[19]	Sainsbury, P., Walk, D., & Grad, J. (1966). Evaluating the Grayingwell Hospital Community Psychiatric Service in Chichester. Millbank Memorial Fund Quarterly, 44, 243-245. http://dx.doi.org/10.2307/3349082
[20]	Selye, H. (1956). The Stress of Life. New York: McGraw-Hill.
[21]	Simon, G. E., Von Korff, M., Saunders, K., Miglioretti, D. L., van Belle, G., & Kessler, R. C. (2006). Associations between Obesity and Psychiatric Disorder in the US Adult Population. Archives of General Psychiatry, 63, 824-830. http://dx.doi.org/10.1001/archpsyc.63.7.824
[22]	Surtees, P. G., Wainwright, N. W. J., Luben, R. N., Wareham, N. J., Bingham, S. A., & Khaw, K. T. (2008). Depression and Ischemic Heart Disease Mortality: Evidence from the EPIC-Norfolk United Kingdom Prospective Cohort Study. American Journal of Psychiatry, 165, 515-523. http://dx.doi.org/10.1176/appi.ajp.2007.07061018
[23]	Thomson, W. (1996). Type of Depression and Results of Mortality. Personality and Individual Differences, 21, 613-615. http://dx.doi.org/10.1016/0191-8869(96)00104-3
[24]	Thomson, W. (2011). Lifting the Shroud of Depression and Mortality: A 49-Year Follow-Up Study. Journal of Affective Disorders, 130, 60-65. http://dx.doi.org/10.1016/j.jad.2010.09.028
[25]	Tsuang, M. T., Woolson, R. F., & Fleming, J. A. (1980). Causes of Death in Schizophrenia and Manic-Depression. British Journal of Psychiatry, 136, 239-242. http://dx.doi.org/10.1192/bjp.136.3.239
[26]	Week, A., & Vaeth, M. (1986). Excess Mortality of Bipolar and Unipolar Manic-Depressive Cardiovascular Death and Manic-Depressive Psychosis. Journal of Affective Disorders, 11, 227-234. http://dx.doi.org/10.1016/0165-0327(86)90074-1
[27]	Wulsin, L. R., & Singal, B. M. (2003). Do Depressive Symptoms Increase the Risk for the Onset of Coronary Disease? A Systematic Quantitative Review. Psychosomatic Medicine, 65, 201-210. http://dx.doi.org/10.1097/01.PSY.0000058371.50240.E3
[28]	Wulsin, L. R., Evans, J. C., Ramachandran, S. V., Murabito, J. M., Kelly-Hayes, M., & Benjamin, E. J. (2005). Depressive Symptoms, Coronary Heart Disease, and Overall Mortality in the Framingham Heart Study. Psychosomatic Medicine, 67, 697-702. http://dx.doi.org/10.1097/01.psy.0000181274.56785.28
[29]	Wulsin, L. R., Valliant, G. E., & Wells, V. E. (1999). A Systematic Review of the Mortality of Depression. Psychosomatic Medicine, 61, 6-17.
[30]	Zheng, D, Macera, C. A., Croft, J. B., Giles, W. H., Davis, D. & Scott, W. K. (1997). Major Depression and All-Cause Mortality among White Adults in the United States. Annals of Epidemiology, 7, 213-218. http://dx.doi.org/10.1016/S1047-2797(97)00014-8