The findings of researchers in genetic psychiatry at Vrije Universiteit Amsterdam and Amsterdam UMC Eco de Geus, Jorien Treur en Brenda Penninx have been published in the scientific journal Nature Cardiovascular Research under the title Genetic perspectives on the co-morbidity of anxiety and mood disorders with cardiovascular disease. These insights can contribute to better collaboration between mental health care and cardiology.
Three causes behind the association
Anxiety and mood disorders, such as depression, occur remarkably often in people with cardiovascular disease. To understand why these conditions so often co-occur, researchers analyzed a large number of genetic and epidemiological studies. This shows that the association between depression and cardiovascular disease is explained by three factors:
• Shared hereditary predisposition: certain genetic factors increase the risk of both psychological and physical disorders.
• Shared environmental influences: for example, a low socioeconomic position, prolonged stress, and unfavorable living conditions.
• A direct effect of depression on cardiovascular disease: people with depression appear to have an increased risk of developing cardiovascular disorders.
No evidence of an inverse relationship
The researchers based their conclusions on, among other things, twin studies and large-scale genetic studies in which DNA differences are investigated. These so-called genetic informative research designs make it possible to better distinguish causal relationships from coincidental associations.
The results indicate that anxiety and mood disorders can increase the risk of cardiovascular disease. The researchers found no convincing evidence for the inverse relationship - that cardiovascular disease leads to psychological disorders.
Results from randomized treatment studies also support this conclusion. Treatment of depression appears to have beneficial effects on cardiovascular health, whereas treatment of cardiovascular disease does not consistently lead to an improvement in psychological symptoms.
Great significance for healthcare
According to the researchers, the findings underscore the importance of a joint approach to mental and physical health. In practice, these are often still treated separately, even though many risk factors actually overlap.
An integrated care approach, in which psychiatrists, psychologists, general practitioners, and cardiologists collaborate, may be able to provide better support to patients. Interventions aimed at stress reduction, lifestyle improvement, and prevention, in particular, seem promising for reducing the double burden of mental and physical health problems.
Societal impact
The results are relevant for a growing group of patients dealing with multiple conditions simultaneously. By recognizing and treating psychological symptoms earlier, the risk of serious cardiovascular disease may also be reduced.
The researchers therefore advocate for more attention to the interplay between mental and physical health. Better collaboration between different medical disciplines can not only improve the quality of life of patients, but also contribute to reducing the societal and economic consequences of chronic disease.