University of Michigan, Department of Psychiatry, Michigan, USA
Depressive and anxiety disorders are common in primary care settings and prevalent in patients with chronic medical illnesses. In patients with existing cardiovascular disease, depression predicts morbidity and death. There is strong evidence for poor post-myocardial infarction (MI) prognosis in patients with depression or depressive symptoms. Approximately 15–20% of acute MI patients have a major depressive disorder and, as multiple longitudinal studies have shown, depression post-MI often persists. Cardiac death risk in the six months after an acute MI is approximately four times greater in patients with depression compared with post-MI nondepressed patients.
We are understanding more about the link between coronary heart disease and post traumatic stress disorder. In a 2013 study of twins, PTSD was found to be independently linked to increase the risk of incident coronary events outside of the influence of genetic factors and behavioural factors.
In addition, many of the psychotropic medications prescribed impact on the QT interval, making dosing and use of some antidepressants and antipsychotic medications, in combination with other classes of medications, and underlying heart disease, life threatening.
This presentation will underscore some of the important themes in Psychiatry and Heart Disease and allow ample time for questions and answers to stimulate audience participation.
Vaccarino et al: Post traumatic stress disorder and incidence of coronary heart disease: a twin study. J Am Coll Cardiol 2013; 63:970-78
Huffman JC et al: Depression and cardiac disease: epidemiology, mechanisms and diagnosis. Cardiovas Psychiatr Neurolog 2013
Riba M, Wulsin L, Rubenfire M: Psychiatry and Heart Disease: The Mind, brain and Heart. Wiiley-Blackwell, 2012