Mental disorders link to heart disease risk

Researchers have identified an increased risk of non-fatal or fatal heart disease across a spectrum of mental conditions, including schizophrenia, bipolar disorder, depression, neurotic disorders, substance-use disorders and personality disorders.

Medical assessment

The study evaluated more than one million Swedish men, born between 1950 and 1976 who underwent psychiatric and medical assessment during military conscription examinations and were then followed up for around 22 years.

Data on coronary heart disease that these men developed was obtained from the Swedish Cause of Death Register and the Country's National Hospital Discharge Register. The Hospital Discharge Register also provided information on psychiatric hospital admissions.

Increased risk of heart disease

The study by researchers at the Universities of Edinburgh and Southampton - and the Karolinska Institute in Stockholm - is published in the journal Circulation.

An increased risk of developing heart disease was evident in men diagnosed with mental disorders at around age 18 and in those who, at a later age, were admitted to hospital for psychiatric disorders.

Researchers say the findings demonstrate that the link between mental disorder and coronary heart disease is not confined to a few disorders or to those whose disorder is severe.

The study indicates the highest risk tended to be in those whose mental condition required hospital admission.

Physical health care

The team investigated whether the link between mental disorder and the subsequent development of coronary heart disease was caused by smoking habits, alcohol intake, blood pressure, diabetes, level of obesity, intelligence or socioeconomic status measured at age 18. However, in general, these factors did not appear to significantly influence any link.

Our findings suggest that mental disorders pose a huge public health burden in terms of premature illness and death due to coronary heart disease. The physical health care of people with mental disorders needs to be a priority for clinicians if this burden is to be reduced.

Dr Catharine Gale

The research was funded by the MRC (Medical Research Council). It was carried out at the Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE) at the University of Edinburgh and the MRC Lifecourse Epidemiology Unit, University of Southampton).