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The impact of mental vulnerability on the relationship between cardiovascular disease and depression

Terese Sara Høj Jørgensen1,2, Marie Kim Wium-Andersen1, Martin Balslev Jørgensen3

  • 1Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.

European Psychiatry : the Journal of the Association of European Psychiatrists
|February 26, 2020
PubMed

Insights

Cardiovascular disease (CVD) strongly predicts depression risk. Mental vulnerability exacerbates this link, highlighting a key group for targeted interventions in CVD and depression prevention.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • The relationship between cardiovascular disease (CVD) and depression is complex and not fully understood.
  • Mental vulnerability's role as a mediator or moderator in this association requires further investigation.

Purpose of the Study:

  • To examine the impact of mental vulnerability on the established link between CVD and depression.
  • To quantify the interaction between CVD and mental vulnerability in predicting depression risk.

Main Methods:

  • Analysis of data from 19,856 individuals across five Copenhagen cohorts, followed from 1983-2011 to 2017.
  • Utilized additive hazard and Cox proportional hazard models to assess confounding and interaction effects.
  • Investigated the association between CVD, mental vulnerability, and the incidence of depression.

Main Results:

  • A significant positive association was found between CVD and depression (HR: 3.60), with 35.4 additional cases per 1,000 person-years.
  • This association was only slightly attenuated by adjustment for mental vulnerability and other confounders.
  • A synergistic interaction was identified: CVD increased depression risk by 50.9 cases per 1,000 person-years in individuals with high mental vulnerability compared to those with low vulnerability.

Conclusions:

  • Mental vulnerability does not explain the strong CVD-depression link but significantly modifies it.
  • Individuals with both CVD and high mental vulnerability represent a critical group for intervention, particularly in rehabilitation settings.
Abstract

Keywords:
cardiovascular diseasedepressionepidemiologyinteraction analysesmental vulnerability

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