Study Finds Increased Risk of Mental Health Disorders Following Cardiovascular Hospitalization

A study published in the Journal of the American Heart Association (AHA) indicated that individuals who were hospitalized after a cardiac event, including heart disease, stroke, and other cardiovascular diseases (CVD), were 83% more likely to be diagnosed with anxiety or depression. The findings emphasize the significant need for improved monitoring and intervention of the mental health challenges experienced by patients after an adverse cardiovascular (CV) event.¹

Patients who experienced stroke were 3 times as likely to develop a psychiatric disorder or attempt suicide within 1 year of hospitalization. Image Credit: © Nuttapong punna - stock.adobe.com

In recent years, studies have investigated the bidirectional relationship between CVD and mental health conditions, such as depression. These findings have indicated that depression is a significant risk factor for the development of CVD, and patients with CVD who experience depression have poorer health outcomes. According to the authors of a study published in March 2024, patients who received psychotherapy or antidepressant medication were 75% less likely to be rehospitalized for a cardiac event.^2,3

The relationship between CVD and depression also works in the reverse: patients who are hospitalized for CVD have an increased risk of developing a psychiatric disorder. However, there has been little research into the potential genetic susceptibility associations among CVD, psychiatric disorders, and suicide attempt. In a study conducted by a team of researchers from China, it was found that patients hospitalized for CVD have an increased risk of psychiatric disorders and suicide, especially in the first year (fully adjusted hazard ratio [HR] within 1 year, 1.83 [95% CI, 1.58–2.12]; HR after 1 year, 1.24 [95% CI, 1.16–1.32]).⁴

The researchers assessed the health records of 63,923 patients (64% men; average age 63 years) who were hospitalized for CVD between 1997 and 2020 compared with 127,845 matched individuals from the UK Biobank. They analyzed the prevalence of psychiatric diagnosis following hospitalization for CVD in the study population. Additionally, using Cox regression models and stratified analyses, they examined the subsequent risk of psychiatric disorders and suicide, as well as any potential genetic susceptibilities in the observed associations.^1,4

Overall, their findings indicated that patients with CVD have an 83% increased risk of developing depression or anxiety following hospitalization for a cardiac event, with a 24% chance up to 8 years later. Patients who experienced stroke were 3 times as likely to develop a psychiatric disorder or attempt suicide within 1 year of hospitalization and a 49% increased risk after 1 year. The researchers noted that genetic predisposition to psychiatric disorders did not increase the risk of CVD and developing depression or anxiety.^1,4

“This study’s findings confirm that after a cardiovascular disease diagnosis and/or hospitalization, patients are at increased risk for mental health conditions, therefore, mental health screening and early intervention are crucial,” Mariell Jessup, MD, FAHA, chief science and medical officer of the American Heart Association, said in a press release. “It’s also critical for patients, family members, loved ones or caregivers to share any changes that may signal depression, anxiety or potential for suicidal behaviors with the health care team.”¹

References

1. Risks of anxiety, suicide attempt may rise significantly after cardiovascular hospitalization. American Heart Association. July 31, 2024. Accessed August 12, 2024. https://newsroom.heart.org/news/risks-of-anxiety-suicide-attempt-may-rise-significantly-after-cardiovascular-hospitalization?preview=dcef&preview_mode=True

2. Heart disease and depression: A two-way relationship. National Heart, Lung, and Blood Institute. April 16, 2017. Accessed August 12, 2024. https://www.nhlbi.nih.gov/news/2017/heart-disease-and-depression-two-way-relationship

3. Carmin C, Ownby R, Fontanela C, et al. Impact of Mental Health Treatment on Outcomes in Patients With Heart Failure and Ischemic Heart Disease. J Am Heart Assoc. March 20, 2024. doi: 10.1161/JAHA.123.031117

4. Yang J, Zeng Y, Yang H, et al. Cardiovascular disease, genetic susceptibility, and risk of psychiatric disorders and suicide attempt: a community-based matched cohort study based on the uk biobank. J Am Heart Assoc. July 31, 2024. doi: 10.1161/JAHA.123.031280