Cardiometabolic disease and features of depression and bipolar disorder: population-based, cross-sectional study
Daniel J Martin1, Zia Ul-Haq1, Barbara I Nicholl1
1Daniel J. Martin, MRCPsych, Institute of Health and Wellbeing, Mental Health, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK; Zia Ul-Haq, PhD, Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK and Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan; Barbara I. Nicholl, PhD, Institute of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK; Breda Cullen, DClinPsy, Jonathan Evans, PhD, Institute of Health and Wellbeing, Mental Health, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK; Jason M. R. Gill, PhD, Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK; Beverly Roberts, PhD, Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK; John Gallacher, PhD, National Centre for Mental Health, Institute of Neurosciences and Mental Health, Cardiff University, Cardiff, UK; Daniel Mackay, PhD, Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK; Andrew McIntosh, MD, FRCPsych, Division of Psychiatry, University of Edinburgh, Edinburgh, UK; Matthew Hotopf, MD, FRCPsych, Institute of Psychiatry, Kings College, London, London, UK; Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, Institute of Neurosciences and Mental Health, Cardiff University, Cardiff, UK; Ian J. Deary, PhD, Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK; Jill P. Pell, MD, Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK; Daniel J. Smith, MD, FRCPsych, Institute of Health and Wellbeing, Mental Health, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK.
Insights
This study found that depression and bipolar disorder are linked to cardiovascular disease, independent of other factors. Psychotropic medications may also increase cardiometabolic disease risk.
Area of Science:
- Psychiatry and Cardiology
- Public Health Research
- Epidemiology
Background:
- The link between affective disorders and cardiometabolic diseases is not fully understood regarding contributing factors.
- Demographic, lifestyle, and medication influences on this association require further investigation.
Purpose of the Study:
- To investigate the relationship between cardiometabolic disease and symptoms of depression and bipolar disorder.
- To analyze these associations within a large UK population sample.
Main Methods:
- A cross-sectional study utilizing UK Biobank data from 145,991 participants.
- Multivariate analyses were performed to assess associations between mood disorder features and five cardiometabolic outcomes, controlling for confounders.
Main Results:
- Significant associations were observed between mood disorder features and cardiovascular disease, as well as hypertension.
- Individuals with mood disorder features on psychotropic medication showed increased odds of myocardial infarction and stroke compared to controls not on psychotropics.
Conclusions:
- The observed associations between affective disorders and cardiovascular disease outcomes were independent of demographic, lifestyle, and medication confounders.
- Psychotropic medication use may represent an independent risk factor for cardiometabolic disease, even in individuals without a distinct history of mood disorders.
Background:
The relative contribution of demographic, lifestyle and medication factors to the association between affective disorders and cardiometabolic diseases is poorly understood.
Aims:
To assess the relationship between cardiometabolic disease and features of depresion and bipolar disorder within a large population sample.
Method:
Cross-sectional study of 145 991 UK Biobank participants: multivariate analyses of associations between features of depression or bipolar disorder and five cardiometabolic outcomes, adjusting for confounding factors.
Results:
There were significant associations between mood disorder features and 'any cardiovascular disease' (depression odds ratio (OR) = 1.15, 95% CI 1.12-1.19; bipolar OR = 1.28, 95% CI 1.14-1.43) and with hypertension (depression OR = 1.15, 95% CI 1.13-1.18; bipolar OR = 1.26, 95% CI 1.12-1.42). Individuals with features of mood disorder taking psychotropic medication were significantly more likely than controls not on psychotropics to report myocardial infarction (depression OR = 1.47, 95% CI 1.24-1.73; bipolar OR = 2.23, 95% CI 1.53-3.57) and stroke (depression OR = 2.46, 95% CI 2.10-2.80; bipolar OR = 2.31, 95% CI 1.39-3.85).
Conclusions:
Associations between features of depression or bipolar disorder and cardiovascular disease outcomes were statistically independent of demographic, lifestyle and medication confounders. Psychotropic medication may also be a risk factor for cardiometabolic disease in individuals without a clear history of mood disorder.
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