Depressed mood and cause-specific mortality: a 40-year general community assessment

Abstract

Purpose The current study describes how the excess mortality risk associated with depression translates into specific causes of death occurring during a 40-year follow-up period, with focus on deaths related to injuries, cardiovascular diseases, and cancer. Methods Data comes from a cross-sectional survey (Community Mental Health Epidemiology Study) conducted in the early 1970s in Washington County, Maryland. Random sampling for the survey resulted in 2762 interviews. For the current analyses, baseline depressed mood was linked to current participant vital status through the use of death certificate records. Results The relative subdistribution hazards for cardiovascular deaths (3.08 (1.74–5.45)) and fatal injuries (4.63 (1.76–12.18)) were significant over the entire 40-year period for young adults (18–39 years old at baseline). The relative subdistribution hazard for cardiovascular deaths during the first 15 years of follow-up was pronounced in elderly (≥ 65 years) males (2.99 (1.67–5.37)). There were no significant associations between depressed mood and cancer deaths. Conclusions Individuals in the general community with depressed mood may be at increased risk of deaths due to cardiovascular disease and injury, even several decades after exposure assessment. Young adults with depressed mood appear to be particularly vulnerable to these associations.

Sex Differences in Mental Stress–Induced Myocardial Ischemia in Young Survivors of an Acute Myocardial Infarction

“…In support of this hypothesis, two recent follow-up studies of young community samples (less than 40 years old) found a dramatic increase in risk of IHD due to depression in young women, which was higher than in men (11,12). Similarly, severe childhood adversities such as physical and sexual abuse are independent risk factors for the incidence of IHD among women (42), and, among participants younger than 55 years, early life stressors are stronger predictors of cardiovascular events in women than in men (10).…”

“…Although these studies have not examined mental stress in the laboratory, they do suggest a profound role of emotional factors on cardiovascular risk in young women. The high prevalence of depression and sexual abuse among women in our sample, particularly those 50 years and younger, likely reflects the fact that these factors are powerful predictors for premature heart disease in young women (10-12). …”

“…The cardiovascular system is deemed susceptible to emotional stress, and young women appear to be especially vulnerable to psychosocial risk factors (9-12). Direct evidence that emotional stress affects disproportionally young women with IHD is limited, however, partly due to methodological limitations in the assessment and quantification of stress.…”

Frequent alcohol, nicotine or cannabis use is common in young persons presenting for mental healthcare: a cross-sectional study

“…7 Young people with mental disorders are at increased risk of later cardiovascular disease. 8 One of the most significant modifiable risk factors in this population appears to be cigarette smoking.…”

Chronic fluoxetine reduces autonomic control of cardiac rhythms in rats with congestive heart failure

“…Moreover, a diagnosis of depression is associated with increased morbidity and mortality in CHF patients. Individuals diagnosed with depression or anxiety disorders without underlying cardiovascular disease at the time of diagnosis also have a greater risk of dying of cardiovascular disease than do individuals without depression (54). As a consequence, increasing numbers of cardiovascular patients are being treated with antidepressant drugs.…”