Spectrum of Depressive Disorders and Cardiovascular Diseases: Clinical and Psychobiological Evidences of a Bidirectional Relationship

Laura Palagini, Rosa Maria Bruno, Mario Guazzelli, Stefano Taddei, Angelo Ge

Introduction

Depression and cardiovascular disease are very common, and often, they coexist, being the prevalence of depression in various cardiac disorders ranges from 15% to 20%.1

Major depression is considered a primary risk factor for the development of cardiovascular diseases, including coronary artery disease (CAD), myocardial infarction (MI), 1–10 and congestive heart failure (CHF). 11–13 An emerging literature suggests also that depression might contribute to hypertension. 14–16 The risk of developing these cardiovascular disorders increases when the depressive disorder is severe.7, 14, 17 Nonetheless, the so-called “minor” or “subthreshold” forms of depression, currently included in the realm of “mood spectrum disorders,”18, 19 have been also recently investigated as conditions potentially related with a higher risk to develop a cardiovascular disease.11,20–22 Vice versa, according to clinical and epidemiological studies, patients with cardiovascular diseases show a twofold to fourfold increased risk to develop a depressive disorder.11, 20, 21

Depression and cardiovascular disease are very common, and they often coexist. Major depression is considered a primary and secondary risk factor for hypertension, coronary artery disease, myocardial Infarction, and congestive heart failure. Nevertheless, depressive episodes, minor depression, dysthymia, and several subsyndromal forms of depression, currently included in the realm of “mood spectrum disorders,” might have a role in the etiology of these cardiovascular diseases. Despite the exact pathways underlying the interplay between depressive spectrum disorders and cardiovascular disease have yet to be elucidated, the existence of a bidirectional relationship has been postulated.

The aim of this manuscript is either to reconsider the clinical evidences of the relationship between depressive spectrum disorders and cardiovascular disease or the hypothesis of a common psychoorganic etiological background by a systematic search from MEDLINE and PsychINFO articles with participants over 18 years.

 

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