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Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease.

dc.contributor.author Blumenthal, James Alan
dc.contributor.author Davidson, Jonathan RT
dc.contributor.author Koch, GG
dc.contributor.author O'Connor, Christopher Michael
dc.contributor.author Sherwood, Andrew
dc.contributor.author Sketch, MH
dc.contributor.author Watkins, LL
dc.coverage.spatial England
dc.date.accessioned 2016-12-01T14:35:14Z
dc.date.issued 2013-03-19
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/23537805
dc.identifier 2/2/e000068
dc.identifier.uri http://hdl.handle.net/10161/13048
dc.description.abstract BACKGROUND: Depression has been related to mortality in coronary heart disease (CHD) patients, but few studies have evaluated the role of anxiety or the role of the co-occurrence of depression and anxiety. We examined whether anxiety is associated with increased risk of mortality after accounting for depression in individuals with established CHD. METHODS AND RESULTS: The cohort was composed of 934 men and women with confirmed CHD (mean age, 62±11 years) who completed the Hospital Anxiety and Depression scale (HADS) during hospitalization for coronary angiography. Over the 3-year follow-up period, there were 133 deaths. Elevated scores on the HADS anxiety subscale (HADS-A≥8) were associated with increased risk of mortality after accounting for established risk factors including age, congestive heart failure, left ventricular ejection fraction, 3-vessel disease, and renal disease (hazard ratio [HR], 2.27; 95% CI, 1.55 to 3.33; P<0.001). Elevated scores on the HADS depression subscale (HADS-D≥8) were also associated with increased risk of mortality (HR, 2.18; 95% CI, 1.47 to 3.22; P<0.001). When both psychosocial factors were included in the model, each maintained an association with mortality (anxiety, HR, 1.83; 95% CI, 1.18 to 2.83; P=0.006; depression, HR, 1.66; 95% CI, 1.06 to 2.58; P=0.025). Estimation of the HR for patients with both anxiety and depression versus those with neither revealed a larger HR than for patients with either factor alone (HR, 3.10; 95% CI, 1.95 to 4.94; P<0.001). CONCLUSIONS: Anxiety is associated with increased risk of mortality in CHD patients, particularly when comorbid with depression. Future studies should focus on the co-occurrence of these psychosocial factors as markers of increased mortality risk.
dc.language eng
dc.relation.ispartof J Am Heart Assoc
dc.relation.isversionof 10.1161/JAHA.112.000068
dc.subject Adult
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Anxiety
dc.subject Anxiety Disorders
dc.subject Cause of Death
dc.subject Cohort Studies
dc.subject Coronary Disease
dc.subject Depression
dc.subject Depressive Disorder
dc.subject Female
dc.subject Follow-Up Studies
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Proportional Hazards Models
dc.subject Prospective Studies
dc.subject Risk Factors
dc.subject Surveys and Questionnaires
dc.title Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/23537805
pubs.begin-page e000068
pubs.issue 2
pubs.organisational-group Center for the Study of Aging and Human Development
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group Medicine, Clinical Pharmacology
pubs.organisational-group Psychiatry & Behavioral Sciences
pubs.organisational-group Psychiatry & Behavioral Sciences, Behavioral Medicine
pubs.organisational-group Psychiatry & Behavioral Sciences, General Psychiatry
pubs.organisational-group Psychology and Neuroscience
pubs.organisational-group School of Medicine
pubs.organisational-group Trinity College of Arts & Sciences
pubs.publication-status Published online
pubs.volume 2
dc.identifier.eissn 2047-9980


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