Severe Mental Illness and Cardiovascular Disease

Goldfarb, Michael; Hert, Marc De; Detraux, Johan; Palo, Katherine Di; Munir, Haroon; Music, Sanela; Piña, Ileana L.; Ringen, Petter Andreas

doi:10.1016/j.jacc.2022.06.017

Cited by 50 publications

(36 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a consequence, older people are less likely to be adequately assessed and treated for CVD, which may be compounded by concomitant SMI (36). These factors may also lead to a reduction in access to or engagement with primary and secondary prevention of CVD, such as smoking cessation services, and physical activity programs (3). People with SMI are more likely to have lower socio-economic status (38), with reduced ability to access healthy diets and physical activity services which require subscriptions.…”

Section: Risk Factors For Cvd In Smimentioning

confidence: 99%

“…Interventions to address SMI in CVD can be considered under two main categories. Firstly, primary prevention strategies targeting risk factors and comorbidities, and secondly, secondary prevention strategies targeting individuals who have already experienced CVD (3).…”

Section: Current Management Of Cvd In Smimentioning

confidence: 99%

“…Anxiety, substance abuse disorders, schizophrenia and bipolar disorder are also seen commonly in older people. Serious mental illness (SMI) is a term used to group several common psychiatric disorders (schizophrenia, bipolar affective disorder and major depressive disorder) which significantly affect functional abilities (3). While the mortality gap remains significant between people living with SMI and the general population, older people with SMI are routinely cared for by old age psychiatrists and have distinct challenges from the younger SMI population (4).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiovascular disease in older people with serious mental illness: Current challenges and future directions

Chin

Ghosh²,

Subramaniam³

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

Cardiovascular disease and SMIPhysical ill health is the most significant factor in the widening mortality gap between SMI and the general population (1). Cardiovascular disease (CVD) is the leading cause of mortality worldwide (8), and the major cause of death in SMI (9), and CVD increases with age (10). The relationship is bidirectional, and those with CVD are also at higher risk of adverse mental health (9). Much of this risk is modifiable through better provision and access to physical healthcare (11). A large meta-analysis of observational studies found higher rates of all CVD sub-types amongst those with SMI, but contemporary data in the UK is lacking (12), the last studies being conducted over a decade ago (13, 14). The average age of participants with SMI was ∼50 years in these studies (12-14), and few studies specifically investigate older populations.

show abstract

Section: Risk Factors For Cvd In Smimentioning

confidence: 99%

Section: Current Management Of Cvd In Smimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular disease in older people with serious mental illness: Current challenges and future directions

Chin

Ghosh²,

Subramaniam³

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Additionally, schizophrenia patients received suboptimal care, in terms of revascularization, secondary prevention measures, including the prescription of statins, beta-blockers, and anti-platelets and follow-up, compared to patients without a psychiatric diagnosis [ 38 ]. Other factors such as poor health literacy, treatment nonadherence, substance abuse and lower socioeconomic status may also contribute to worse cardiovascular outcomes, whereas those patients may have several barriers to access the healthcare system and may experience disparities that undermine optimal care [ 39 ]. The interplay of factors that contribute to mortality from cardiovascular disease is depicted in Figure 1 .…”

Section: Causes Of Mortalitymentioning

confidence: 99%

Mortality in Schizophrenia-Spectrum Disorders: Recent Advances in Understanding and Management

Peritogiannis

Ninou²,

Samakouri

2022

Healthcare

View full text Add to dashboard Cite

Schizophrenia is a life-shortening disease and life expectancy in patients may be 15–20 years shorter than in the general population, with increasing longevity gap over time. Premature mortality in schizophrenia-spectrum disorders is mainly due to preventable natural causes, such as cardio-vascular disease, infections, respiratory tract diseases and cancer, alongside suicide, homicide and accidents. There is a complex interplay of factors that act synergistically and cause physical morbidity to patients and subsequent mortality. Smoking, alcohol/substance abuse and sedentary life style, alongside disease-related factors, such as metabolic abnormalities and accelerating aging contribute to physical morbidity. Moreover, the symptomatology of psychosis and stigma may limit patients’ access to quality medical care. Interventions to promote physical health in those patients should be multifaceted, and should target all patient-related modifiable factors, but also should address service-related healthcare disparities. Long-term antipsychotic use (including clozapine and long-acting injectables) is associated with substantially decreased all-cause mortality, including suicide and cardiovascular mortality, in patients with schizophrenia despite the well-known cardiometabolic adverse effects of second-generation agents. Integrated care may involve co-location of physical and mental health services, liaison services, shared protocols and information sharing systems, and has emerged as a way to address the physical health needs of those patients. Interventions to address mortality in schizophrenia and related syndromes should take place as early as possible in the course of the patients’ treatment, and could be an integral component of care delivered by specialized early intervention services.

show abstract

“…[8] Individuals with severe mental illnesses are at a higher risk of developing cardiovascular disease and vice versa. [11] Individuals with depression are about one-third more likely than those without depression to develop chronic heart disease (CHD), myocardial infarction (MI), and coronary death. [8] Furthermore, those with anxiety also have a 41% increased risk for developing CHD.…”

Section: Introductionmentioning

confidence: 99%

Mental Health and the Youth Athlete: An Analysis of the HeartBytes Database

Vyas

Sun

Farber

et al. 2023

Preprint

View full text Add to dashboard Cite

Background There is a high rate of mental health conditions among the youth athlete population; however, there is limited information about the impact mental health disorders can have on their overall health and athletic performance. Methods Data was collected by Simon’s Heart, a nonprofit organization that coordinates pre-participation examinations (PPE) for adolescents. Multivariable logistic regression adjusting for age, gender, race, BMI, asthma, anemia, and participation in sports was performed to assess the relationship between mental health disorders and each outcome. Results The HeartBytes dataset is composed of screening data from 7425 patients ranging from 12 to 20 years old. We identified 565 patients (7.6%) diagnosed with ADHD and 370 patients (5.0%) diagnosed with anxiety/depression. Screened participants without a diagnosis of ADHD, anxiety, or depression were significantly more likely to play sports compared to those with these conditions (75.4% vs 59.4%, P < 0.001 for ADHD; 89.4% vs 72.4%, P < 0.001 for anxiety/depression). Those with anxiety/depression not on an antidepressant (OR: 2.09, CI: 1.31–3.19, P < 0.01), but not those on an antidepressant (OR: 1.87, CI: 0.96–3.33, P = 0.05), were more likely to report chest pain or dyspnea with exercise. Those with ADHD not on a stimulant (aOR 1.91, CI 1.22–2.89, p < 0.01), but not those on a stimulant (aOR 1.40, CI 0.82–2.24, p = 0.19) were more likely to report palpitations. ECG abnormalities were not more prevalent regardless of anxiety/depression, ADHD, or medical therapy with an antidepressant or a stimulant. Conclusion Young athletes with anxiety/depression were less likely to participate in sports than healthy individuals. This may be due to deterrence as a result of the symptoms, such as dyspnea or chest pain, they experience during exercise. However, those taking antidepressants had fewer symptoms during exercise. Given that exercise has been shown to improve depression/anxiety, increasing the rate of antidepressant use may lead to less symptoms, more exercise, and an overall improvement in the mental health conditions in this population.

show abstract

Severe Mental Illness and Cardiovascular Disease

Cited by 50 publications

References 102 publications

Cardiovascular disease in older people with serious mental illness: Current challenges and future directions

Cardiovascular disease in older people with serious mental illness: Current challenges and future directions

Mortality in Schizophrenia-Spectrum Disorders: Recent Advances in Understanding and Management

Mental Health and the Youth Athlete: An Analysis of the HeartBytes Database

Contact Info

Product

Resources

About