O'Neil, A and Williams, ED and Stevenson, CE and Oldenburg, B and Berk, M and Sanderson, K, Co-morbid cardiovascular disease and depression: sequence of disease onset is linked to mental but not physical self-rated health. Results from a cross-sectional, population-based study, Social Psychiatry and Psychiatric Epidemiology, 47, (7) pp. 1145-1151. ISSN 1433-9285 (2012) [Refereed Article]
Copyright 2011 Springer-Verlag
Purpose: Self-rated health has been linked to important health and survival outcomes in individuals with co-morbid depression and cardiovascular disease (CVD). It is not clear how the timing of depression onset relative to CVD onset affects this relationship. We aimed to first identify the prevalence of major depressive disorder (MDD) preceding CVD and secondly determine whether sequence of disease onset is associated with mental and physical self-rated health.
Methods: This study utilised cross-sectional, populationbased data from 224 respondents of the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). Participants were those diagnosed with MDD and reported ever having a heart/circulatory condition over their lifetime. Age of onset was reported for each condition. Logistic regression was used to explore differences in self-rated mental and physical health for those reporting pre-cardiac and post-cardiac depression.
Results: The proportion of individuals in whom MDD preceded CVD was 80.36% (CI: 72.5788.15). One-fifth (19.64%, CI: 11.8527.42) reported MDD onset at the time of, or following, CVD. After controlling for covariates, the final model demonstrated that those reporting post-cardiac depression were significantly less likely to report poor selfrated mental health (OR:0.36, CI: 0.140.93) than those with pre-existing depression. No significant differences were found in self-rated physical health between groups (OR:0.90 CI: 0.382.14).
Conclusions: MDD is most common prior to the onset of CVD. Further, there is an association between pre-morbid MDD and poorer self-rated mental health. To our knowledge, this is the first time this has been demonstrated in a national, population-based survey. As self-rated health has been shown to predict important outcomes such as survival, we recommend that those with MDD be identified as vulnerable to CVD onset and poorer health outcomes.
|Item Type:||Refereed Article|
|Keywords:||cardiovascular disease, depression, self-rated mental health, self-rated physical health, co-morbidity|
|Research Division:||Health Sciences|
|Research Group:||Health services and systems|
|Research Field:||Health services and systems not elsewhere classified|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Sanderson, K (Associate Professor Kristy Sanderson)|
|Year Published:||2012 (online first 2011)|
|Web of Science® Times Cited:||21|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||2 View Download Statistics|
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