Cardiovascular Disease, Genetic Susceptibility, and Risk of Psychiatric Disorders and Suicide Attempt: A
Jie Yang1,2, Yu Zeng2,3, Huazhen Yang2,3
1Department of Critical Care Medicine and West China Biomedical Big Data Center West China Hospital Sichuan University Chengdu China.
Insights
Cardiovascular disease patients face a higher risk of psychiatric disorders and suicide attempts, especially within the first year post-hospitalization. Genetic factors did not significantly influence these increased risks.
Area of Science:
- Psychiatry
- Cardiology
- Genetics
Background:
- The link between cardiovascular disease (CVD) and psychiatric disorders, including suicide attempts, requires further clarification.
- The role of genetic susceptibility in these associations remains unclear.
Purpose of the Study:
- To investigate the subsequent risk of psychiatric disorders and suicide attempt in patients with CVD.
- To determine if genetic predispositions influence the association between CVD and psychiatric conditions.
Main Methods:
- A matched cohort study using UK Biobank data (63,923 CVD patients and 127,845 controls).
- Cox models analyzed the risk of psychiatric disorders and suicide attempt post-CVD.
- Stratified analyses by polygenic risk scores examined genetic susceptibility's impact.
Main Results:
- CVD patients showed a significantly increased risk of psychiatric disorders and suicide attempt compared to controls.
- This elevated risk was particularly pronounced within the first year following CVD hospitalization (HR 1.83).
- Genetic predisposition had minimal impact on the observed associations between CVD and psychiatric conditions.
Conclusions:
- Hospitalization for CVD increases the risk of subsequent psychiatric disorders and suicide attempts, especially within the first year.
- These risks appear independent of genetic susceptibility to psychiatric conditions.
- Timely psychological interventions are crucial for CVD patients due to their heightened vulnerability.
Background:
The associations between cardiovascular disease (CVD) and multiple psychiatric disorders and suicide attempt, and whether different genetic susceptibilities affect such links, have not been investigated clearly.
Methods And Results:
Based on the UK Biobank, we conducted a matched cohort study involving 63 923 patients who were first hospitalized with a CVD diagnosis between 1997 and 2020, and their 127 845 matched unexposed individuals. Cox models were used to examine the subsequent risk of psychiatric disorders and suicide attempt (ie, anxiety, depression, stress-related disorder, substance misuse, psychotic disorder, and suicide behaviors) following CVD. We further performed stratified analyses by polygenic risk score for each studied psychiatric condition to detect the possible effects of genetic susceptibility on the observed associations. We found an increased risk of any psychiatric disorders and suicide attempt among CVD patients, compared with matched unexposed individuals, particularly within 1 year following the CVD (fully adjusted hazard ratio [HR] within 1 year, 1.83 [95% CI, 1.58-2.12]; HR after 1 year, 1.24 [95% CI, 1.16-1.32]). By subtype, the risk elevations existed for any psychiatric disorders and suicide attempt following most categories of CVDs. Analyses stratified by polygenic risk score revealed little impact of genetic predisposition to studied psychiatric conditions on these observed links.
Conclusions:
Patients hospitalized for CVD were at increased subsequent risk of multiple types of psychiatric disorders and suicide attempt, especially in the first year after hospitalization, irrespective of their genetic susceptibilities to studied psychiatric conditions, and these findings underscore the necessity of developing timely psychological interventions for this vulnerable population.
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