Centre for Cognitive Ageing & Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK (C.R.G., G.D.B.); MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK (C.R.G.); Department of Epidemiology and Public Health, University College London, London, UK (G.D.B.); University College London Mental Health Sciences Unit, University College London, London, UK (D.P.J.O.); Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden (P.T., F.R.); and Centre for Epidemiology and Community Medicine Stockholm County Council, Health Care Services, Stockholm, Sweden (P.T., F.R.).
Circulation. 2014 Jan 14;129(2):186-93. doi: 10.1161/CIRCULATIONAHA.113.002065. Epub 2013 Nov 4.
Depression, anxiety, and psychotic disorders have been associated with an increased risk of coronary heart disease (CHD). It is unclear whether this association between mental health and CHD is present across a wider range of mental disorders.
Participants were 1 107 524 Swedish men conscripted at a mean age of 18.3 years. Mental disorders were assessed by psychiatric interview on conscription, and data on hospital admissions for mental disorder and CHD were obtained from national registers during 22.6 years of follow-up. An increased risk of incident CHD was evident across a range of mental disorders whether diagnosed at conscription or on later hospital admission. Age-adjusted hazard ratios (95% confidence intervals) according to diagnoses at conscription ranged from 1.30 (1.05, 1.62) (depressive disorders) to 1.90 (1.58, 2.38) (alcohol-related disorders). [corrected]. The equivalent figures according to diagnoses during hospital admission ranged from 1.49 (1.24-1.80) (schizophrenia) to 2.82 (2.53-3.13) (other substance use disorders). Associations were little changed by adjustment for parental socioeconomic status, or body mass index, diabetes mellitus, and blood pressure measured at conscription, but they were partially attenuated by the adjustment for smoking, alcohol intake, and intelligence measured at conscription, and for education and own socioeconomic position.
Increased risk of incident CHD is present across a range of mental disorders and is observable when the disorders are diagnosed at a young age.
抑郁、焦虑和精神障碍与冠心病（CHD）风险增加有关。目前尚不清楚心理健康与 CHD 之间的这种关联是否存在于更广泛的精神障碍范围内。
参与者为 1107524 名在平均年龄为 18.3 岁时应征入伍的瑞典男性。通过入伍时的精神病学访谈评估精神障碍，通过全国登记册获得入伍后 22.6 年期间的精神障碍和 CHD 住院数据。在一系列精神障碍中，无论在入伍时诊断还是后来在住院时诊断，均存在 CHD 发病风险增加。根据入伍时的诊断，年龄调整后的风险比（95%置信区间）范围为 1.30（1.05，1.62）（抑郁障碍）至 1.90（1.58，2.38）（酒精相关障碍）。校正后，根据住院期间的诊断，风险比范围为 1.49（1.24-1.80）（精神分裂症）至 2.82（2.53-3.13）（其他物质使用障碍）。在调整了父母的社会经济地位、入伍时的体重指数、糖尿病和血压后，这些关联变化不大，但在调整了入伍时的吸烟、饮酒和智力、教育和自身社会经济地位后，这些关联部分减弱。
在一系列精神障碍中，CHD 的发病风险增加，并且在这些障碍在年轻时被诊断出时就可以观察到。
