Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 7, pp 1145–1151 | Cite as

Co-morbid cardiovascular disease and depression: sequence of disease onset is linked to mental but not physical self-rated health. Results from a cross-sectional, population-based study

  • Adrienne O’NeilEmail author
  • Emily D. Williams
  • Christopher E. Stevenson
  • Brian Oldenburg
  • Michael Berk
  • Kristy Sanderson
Original Paper

Abstract

Purpose

Self-rated health has been linked to important health and survival outcomes in individuals with co-morbid depression and cardiovascular disease (CVD). It is not clear how the timing of depression onset relative to CVD onset affects this relationship. We aimed to first identify the prevalence of major depressive disorder (MDD) preceding CVD and secondly determine whether sequence of disease onset is associated with mental and physical self-rated health.

Methods

This study utilised cross-sectional, population-based data from 224 respondents of the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). Participants were those diagnosed with MDD and reported ever having a heart/circulatory condition over their lifetime. Age of onset was reported for each condition. Logistic regression was used to explore differences in self-rated mental and physical health for those reporting pre-cardiac and post-cardiac depression.

Results

The proportion of individuals in whom MDD preceded CVD was 80.36% (CI: 72.57–88.15). One-fifth (19.64%, CI: 11.85–27.42) reported MDD onset at the time of, or following, CVD. After controlling for covariates, the final model demonstrated that those reporting post-cardiac depression were significantly less likely to report poor self-rated mental health (OR:0.36, CI: 0.14–0.93) than those with pre-existing depression. No significant differences were found in self-rated physical health between groups (OR:0.90 CI: 0.38–2.14).

Conclusions

MDD is most common prior to the onset of CVD. Further, there is an association between pre-morbid MDD and poorer self-rated mental health. To our knowledge, this is the first time this has been demonstrated in a national, population-based survey. As self-rated health has been shown to predict important outcomes such as survival, we recommend that those with MDD be identified as vulnerable to CVD onset and poorer health outcomes.

Keywords

Cardiovascular disease Depression Self-rated mental health Self-rated physical health Co-morbidity 

Notes

Acknowledgments

This work was supported by a Post Graduate Award from the National Heart Foundation of Australia (PP 08M4079)(AO), a Diabetes UK Moffat Travelling Fellowship (EDW), a NHMRC Health Services Research Grant (465130)(CES) and an Australian Research Council Future Fellowship (FT991524)(KS). The authors gratefully acknowledge the Australian Bureau of Statistics for conducting the survey and the Commonwealth Department of Health and Ageing for funding the survey.

References

  1. 1.
    World Health Organisation (2008) The Global Burden of Disease 2004 Update. GenevaGoogle Scholar
  2. 2.
    Moussavi S et al (2007) Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 370(9590):851–858Google Scholar
  3. 3.
    Nabi H et al (2010) Effects of depressive symptoms and coronary heart disease and their interactive associations on mortality in middle-aged adults: the Whitehall II cohort study. Heart 96:1645–1650Google Scholar
  4. 4.
    Maes M et al (2011) Multiple aberrations in shared inflammatory and oxidative & nitrosative stress (IO&NS) pathways explain the co-association of depression and cardiovascular disorder (CVD), and the increased risk for CVD and due mortality in depressed patients. Prog Neuropsychopharmacol Biol Psychiatry 35(3):769–783PubMedCrossRefGoogle Scholar
  5. 5.
    Wulsin LR, Singal BM (2003) Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med 65(2):201–210PubMedCrossRefGoogle Scholar
  6. 6.
    Hemingway H, Marmot M (1999) Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. BMJ 318(7196):1460–1467PubMedCrossRefGoogle Scholar
  7. 7.
    Lesperance F, Frasure-Smith N, Talajic M (1996) Major depression before and after myocardial infarction: its nature and consequences. Psychosom Med 58(2):99–110PubMedGoogle Scholar
  8. 8.
    Keller MB et al (1983) Predictors of relapse in major depressive disorder. JAMA 250(3299–3304)Google Scholar
  9. 9.
    Lesperance F et al (2002) Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction. Circulation 105(9):1049–1053PubMedCrossRefGoogle Scholar
  10. 10.
    Parashar S et al (2006) Time course of depression and outcome of myocardial infarction. Arch Intern Med 166(18):2035–2043PubMedCrossRefGoogle Scholar
  11. 11.
    Singh-Manoux A, Marmot MG, Adler NE (2005) Does subjective social status predict health and change in health status better than objective status? Psychosom Med 67(6):855–861PubMedCrossRefGoogle Scholar
  12. 12.
    Molarius A, Janson S (2002) Self-rated health, chronic diseases, and symptoms among middle-aged and elderly men and women. J Clin Epidemiol 55:364–370PubMedCrossRefGoogle Scholar
  13. 13.
    Borg V, Kristensen TS (2000) Social class and self-rated health: can the gradient be explained by differences in life style or work environment. Soc Sci Med 5:1019–1030CrossRefGoogle Scholar
  14. 14.
    Kamphuis MH et al (2009) The association of depression with cardiovascular mortality is partly explained by health status. The FINE Study. J Affect Disord 114(1):184–192PubMedCrossRefGoogle Scholar
  15. 15.
    Ruo B et al (2006) Self-rated health among women with coronary disease: Depression is as important as recent cardiovascular events. Am Heart J 152(5):921.e1–921.e7Google Scholar
  16. 16.
    Scott KM et al (2010) Chronic physical conditions and their association with first onset of suicidal behavior in the world mental health surveys. Psychosom Med 72(7):712–719PubMedCrossRefGoogle Scholar
  17. 17.
    Williams LJ et al (2009) Depression and bone metabolism. A review. Psychother Psychosom 78(1):16–25PubMedCrossRefGoogle Scholar
  18. 18.
    Australian Bureau of Statistics (2007) National Survey of Mental Health and Wellbeing of Adults, Users’ Guide. ABS, CanberraGoogle Scholar
  19. 19.
    Slade T et al (2009) 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Aust NZ J Psychiatry 43:594–605CrossRefGoogle Scholar
  20. 20.
    Rosencranz H, Pihlblad CT (1970) Measuring the health of the elderly. J Gerontol 25:129–133PubMedGoogle Scholar
  21. 21.
    Idler E, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37PubMedCrossRefGoogle Scholar
  22. 22.
    World Health Organization (2008) Global database on body mass index. World Health Organization, GenevaGoogle Scholar
  23. 23.
    Kessler R, Mroczek D (1994) Final versions of our non-specific psychological distress scale. Institute for Social Research, University of Michigan, MichiganGoogle Scholar
  24. 24.
    Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, New YorkCrossRefGoogle Scholar
  25. 25.
    von Elm E et al (2008) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349CrossRefGoogle Scholar
  26. 26.
    Pasco JA et al (2010) Association of high-sensitivity C-reactive protein with de novo major depression. Br J Psychiatry 197:372–377PubMedCrossRefGoogle Scholar
  27. 27.
    Pasco JA et al (2006) High-sensitivity C-reactive protein and fracture risk in elderly women. JAMA 296(11):1353–1355PubMedCrossRefGoogle Scholar
  28. 28.
    Chiu C et al (2010) The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach. Soc Psychiatry Psychiatr Epidemiol 45(1):67–76PubMedCrossRefGoogle Scholar
  29. 29.
    Jacka FN et al (2010) Association of Western and traditional diets with depression and anxiety in women. Am J Psychiatry 167(3):305–311PubMedCrossRefGoogle Scholar
  30. 30.
    Pasco JA et al (2011) Habitual physical activity and the risk for depressive and anxiety disorders among older men and women. Int Psychogeriatr 2:292–298CrossRefGoogle Scholar
  31. 31.
    Pasco JA et al (2008) Tobacco smoking as a risk factor for major depressive disorder: population-based study. Br J Psychiatry 193(4):322–326PubMedCrossRefGoogle Scholar
  32. 32.
    Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ (1996) Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. J Clin Epidemiol 49:1407–1417Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Adrienne O’Neil
    • 1
    • 5
    Email author
  • Emily D. Williams
    • 1
  • Christopher E. Stevenson
    • 1
  • Brian Oldenburg
    • 1
  • Michael Berk
    • 2
    • 3
  • Kristy Sanderson
    • 4
  1. 1.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  2. 2.School of MedicineDeakin UniversityMelbourneAustralia
  3. 3.Mental Health Research InstituteOrygen Research Centre and The University of MelbourneMelbourneAustralia
  4. 4.Menzies Research Institute Tasmania, University of TasmaniaTasmaniaAustralia
  5. 5.International Public Health UnitMonash UniversityMelbourneAustralia

Personalised recommendations