Depression, Anxiety, and Cognitive Impairment
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Purpose of Review
Depression, anxiety, and cognitive impairment constitute established risk markers for incident cardiovascular disease (CVD) and are associated with impaired life expectancy and quality of life and high hospitalization rates and healthcare expenditure. This review summarizes current knowledge about mental health disorders in patients with CVD and heart failure (HF).
Emerging evidence suggests various shared pathophysiological mechanisms between psychological comorbidities and CVD (e.g., systemic inflammation and autonomic dysfunction). Bi-directional interactions involving the central nervous and cardiovascular systems may help explain the rising prevalence of comorbid mood disorders with increasing CVD severity and support the concept of alternative pathophysiological mechanisms in the presence of severe somatic illness, making symptoms less responsive or unresponsive to psychotropic pharmacotherapy.
Considering high prevalence and negative impact of psychological comorbidities in CVD and HF, routine care should integrate screening for these conditions. Multidisciplinary treatment approaches with active patient participation in disease management were shown to improve outcomes. However, better understanding of factors mediating the adverse prognostic effects of mood disorders is needed. This might enable more targeted treatment and possibly also facilitate better understanding of the pathophysiological mechanisms driving CVD.
KeywordsHeart failure Depression Anxiety Cognitive dysfunction Morbidity Mortality
With permission of the publisher, this article is an updated and extended version of a chapter included in Cardv. Med., David S. Feldman and Paul Mohacsi (Eds): Heart Failure, 978-3-319-98182-6, 335068_1_En, (Chapter 13, Wallenborn J, Angermann CEA. Psychological Comorbidities in Heart Failure). Springer Nature 2018.
Compliance With Ethical Standards
Conflict of Interest
The authors declare no conflicts of interest.
Christiane E. Angermann is a section editor of Current Heart Failure Reports.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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