Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease: A meta-analysis

Abstract

Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease patients remain unquantified. Systematic searching of Medline, Embase, SCOPUS and PsycINFO databases revealed 1025 unique citations. Aggregate generalized anxiety disorder prevalence (12 studies, N = 3485) was 10.94 per cent (95% confidence interval: 7.8-13.99) and 13.52 per cent (95% confidence interval: 8.39-18.66) employing Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria (random effects). Lifetime generalized anxiety disorder prevalence was 25.80 per cent (95% confidence interval: 20.84-30.77). In seven studies, modest correlation was evident between generalized anxiety disorder and depression, Fisher's Z = .30 (95% confidence interval: .19-.42), suggesting that each psychiatric disorder is best conceptualized as contributing unique variance to coronary heart disease prognosis.

A systematic review of reviews on the prevalence of anxiety disorders in adult populations

“…studies 39 Meta‐analysis: no End‐of‐life CHF, COPD, CRF patients Mean age: 38–86 Sample size: not rep. Proxies and patients recruited, chart/medical record review CHF: 2–49% (anxiety prev) COPD: 32–57% CRF: 20–41% CRF terminal: 25% Solano 2006 Search: June 2004 # incl. studies 64 Meta‐analysis: no Adults with advanced cancer, AIDS, heart disease, COPD, renal disease Range: 19–10,379 Medical records, interviews with patients’ families, proxies used, prescriptions for psychotropic drugs Some studies conducted in clinical settings Prev of anxiety symptoms: Cancer: 13–79% AIDS: 8–34% Heart disease: 49% COPD: 51–75% Renal disease: 39–70% Tully 2013 Search: May 2011 # incl. studies 12 Meta‐analysis: yes Older people: median age: 60 years Range: 86–1015 Primary care sample, CHD patients attending rehab, outpatient clinic, people going in for surgery Clinical studies Mostly US studies Diagnostic interview tools GAD prevalence: 10.94% (7.8, 14.0) Lifetime GAD: 25.8% (20.84, 30.8) Clarke 2009 Search: May 2003 # incl.…”

“…different estimates in last week vs. last year of life); patient characteristics; definition and measurement of symptoms Review NR 5 Solano 2006 Search: June 2004 # incl. studies 64 Meta‐analysis: no Original studies Heterogeneity in definition of symptoms (different criteria), methods to detect cases of symptoms (different questionnaires and screening methods used), study design, sampling, study setting, methods of data collection 5 Tully 2013 Search: May 2011 # incl. studies 12 Meta‐analysis: yes Further GAD research in CHD Specific anxiety disorders rather than trait/state anxiety “Any anxiety” not clinically informative in cardiac settings Original studies Heterogeneity: diagnostic criteria for GAD, gender ratio, patient age Review Low rate of publications on GAD 6 Clarke 2009 Search: May 2003 # incl.…”

A dynamic view of comorbid depression and generalized anxiety disorder symptom change in chronic heart failure: the discrete effects of cognitive behavioral therapy, exercise, and psychotropic medication

“…Among the anxiety disorders generalized anxiety disorder (GAD) is the most commonly comorbid disorder with major depression in CVD [32,33]. Recent research shows that GAD increases the risk for CVD morbidity and portends poorer prognosis [34][35][36].…”

Personality disorders in heart failure patients requiring psychiatric management: Comorbidity detections from a routine depression and anxiety screening protocol

“…Anxiety was included in addition to depression screening as the American Heart Association (Lichtman et al, 2008) guidelines advocate comprehensive assessment of anxiety disorders. Also, anxiety disorders are highly prevalent in heart diseases and predict higher rates of cardiovascular morbidity and mortality in patients with heart disease (Frasure-Smith and Lespérance, 2008;Haworth et al, 2005;Tully and Cosh, 2013). Ineligibility criteria for psychology referral were currently receiving psychology and/or psychiatrist support elsewhere.…”