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Depression, Anxiety, and Cognitive Impairment : Comorbid Mental Health Disorders in Heart Failure

Christiane E Angermann1, Georg Ertl2

  • 1Department of Internal Medicine I and Comprehensive Heart Failure Center, University and University Hospital of Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany. Angermann_C@ukw.de.

Current Heart Failure Reports
|November 8, 2018
PubMed

Insights

Mental health disorders like depression and anxiety are linked to cardiovascular disease (CVD) and heart failure (HF). Shared mechanisms and bidirectional interactions highlight the need for integrated screening and multidisciplinary care for better patient outcomes.

Area of Science:

  • Cardiology
  • Psychiatry
  • Psychosomatic Medicine

Background:

  • Mental health disorders, including depression, anxiety, and cognitive impairment, are recognized risk markers for cardiovascular disease (CVD).
  • These psychological comorbidities are associated with reduced life expectancy, diminished quality of life, increased hospitalizations, and elevated healthcare costs in patients with CVD and heart failure (HF).

Purpose of the Study:

  • To review current knowledge on the relationship between mental health disorders and cardiovascular disease (CVD) and heart failure (HF).
  • To explore shared pathophysiological mechanisms and bidirectional interactions between psychological comorbidities and CVD.

Main Methods:

  • Literature review summarizing existing research on mental health in CVD and HF patients.
  • Analysis of emerging evidence on shared pathophysiological pathways, such as systemic inflammation and autonomic dysfunction.

Main Results:

  • Shared pathophysiological mechanisms, including inflammation and autonomic dysfunction, link psychological comorbidities with CVD.
  • Bidirectional interactions between the nervous and cardiovascular systems may explain the increased prevalence of mood disorders with CVD severity.
  • Symptoms of mood disorders in severe somatic illness may be less responsive to standard psychotropic pharmacotherapy.

Conclusions:

  • Routine screening for mental health disorders in patients with CVD and HF is recommended due to their high prevalence and negative impact.
  • Multidisciplinary treatment approaches incorporating active patient participation can improve outcomes.
  • Further research is needed to understand factors mediating the adverse prognostic effects of mood disorders to enable targeted treatments and elucidate CVD mechanisms.
Abstract

Keywords:
AnxietyCognitive dysfunctionDepressionHeart failureMorbidityMortality

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