The intriguing relationship between coronary heart disease and mental disorders.
The intriguing relationship between coronary heart disease and mental disorders.
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DOI：
10.31887/dcns.2018.20.1/mdehert
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发表时间：
2018-03
影响因子：
8.3
通讯作者：
Vancampfort D
中科院分区：
文献类型：
--
作者：
De Hert M;Detraux J;Vancampfort D
冠心病(CHD)和精神疾病是全球发病率和死亡率的主要原因。几十年的研究揭示了冠心病和精神疾病之间的几个联系，有时甚至令人惊讶，甚至表明两者实际上可能是彼此造成的。然而，这些联系的确切性质尚未明确确定。因此，这篇论文的目的是全面回顾和讨论精神疾病和冠心病之间双向联系的流行病学和病理生理学方面的最新进展。这篇综述表明，有大量的流行病学前瞻性数据表明，患有严重精神疾病，包括精神分裂症、双相情感障碍和严重抑郁障碍的人，与对照组相比，患冠心病的风险增加[调整后的危险比(ADJHR)=1.5 4；95%CI：1.3 0~1.82，P<；0.0001]。焦虑症状或障碍(相对危险度RR=1.41，95%CI：1.23~1.61，P<；0.0001)，以及持续或强烈应激或创伤后应激障碍的经历(ADJHR=1.27，95%CI：1.08~1.49)，虽然程度较小，但也可能与发生冠心病的风险增加独立相关。另一方面，研究还表明，这些症状/精神疾病在冠心病患者中很常见，可能与心血管发病率和死亡率的大幅增加有关。最后，精神疾病和CHD似乎有共同的病因，包括生物、行为、心理和遗传机制。
Coronary heart disease (CHD) and mental illness are among the leading causes of morbidity and mortality worldwide. Decades of research has revealed several, and sometimes surprising, links between CHD and mental illness, and has even suggested that both may actually cause one another. However, the precise nature of these links has not yet been clearly established. The goal of this paper, therefore, is to comprehensively review and discuss the state-of-the-art nature of the epidemiological and pathophysiological aspects of the bidirectional links between mental illness and CHD. This review demonstrates that there exists a large body of epidemiological prospective data showing that people with severe mental illness, including schizophrenia, bipolar disorder, and major depressive disorder, as a group, have an increased risk of developing CHD, compared with controls [adjusted hazard ratio (adjHR)=1.54; 95% CI: 1.30-1.82, P<0.0001]. Anxiety symptoms or disorders (Relative Risk (RR)=1.41, 95% CI: 1.23-1.61, P<0.0001), as well as experiences of persistent or intense stress or posttraumatic stress disorder (PTSD) (adjHR=1.27, 95% CI: 1.08-1.49), although to a lesser degree, may also be independently associated with an increased risk of developing CHD. On the other hand, research also indicates that these symptoms/mental diseases are common in patients with CHD and may be associated with a substantial increase in cardiovascular morbidity and mortality. Finally, mental diseases and CHD appear to have a shared etiology, including biological, behavioral, psychological, and genetic mechanisms.