Psychiatric multimorbidity in heart failure

There have been numerous studies of specific psychiatric comorbidities such as major depression in patients with heart disease, but there have been relatively few studies of psychiatric multimorbidity in these patients. The purpose of this cross-sectional study was to investigate the prevalence and correlates of psychiatric multimorbidity in patients with heart failure (HF).

Patients who had been hospitalized with HF were enrolled in this cross-sectional study within 30 days of hospital discharge and interviewed within two weeks after enrollment. Participants completed the NetSCID-5 diagnostic interview, a social determinants of health (SDOH) interview, and perceived stress and health-related quality of life questionnaires.

A total of 362 patients completed the interview. The maximum possible lifetime comorbidity count was 11 but the observed maximum was 8; the mean (SD) count was 1.48 (1.63). A total of 135 (37 %) patients had no history of any psychiatric disorder, 97 (27 %) had a lifetime history of a single disorder, and 130 (36 %) had ≥2 lifetime disorders. Higher numbers of psychiatric disorders were associated with younger age, more exposure to SDOH, higher perceived stress, and chronic obstructive pulmonary disease.

Psychiatric multimorbidity is prevalent in patients with HF and is associated with worse medical and social health status. New studies of the consequences or treatment of specific psychiatric comorbidities in patients with heart disease should take psychiatric multimorbidity into account, and further research on psychiatric multimorbidity per se is needed.