Mental disorders and cardiovascular disease: what should we be looking out for?
Matthias Michal, Manfred E. Beutel
Abstract
### Learning objectives Mental disorders are prevalent. They impair patients’ quality of life severely and are associated with an increased risk of developing cardiovascular disease (CVD) and worse prognosis.1–4 Although these facts have been well established, there is still a gap in diagnostic awareness and treatment of mental disorders in patients with CVD.5–8 Therefore, we aim to educate cardiologists about the importance of mental disorders and how to address the widely unmet healthcare needs of patients with a mental disorder in their clinical practice. ### Mental disorders increase the risk for subsequent CVD All mental disorders are associated with an increased risk of developing CVD.9–11 As an example, we show the risk estimates from a recent extensive population-based cohort study from the Danish national registries, observing 5.9 million persons for 15 years (table 1).10 In general, the risk of developing CVD increases with the number of comorbid mental disorders, for example, from 1.5-fold to 3.0-fold for one as compared with five diagnoses.11 View this table: Table 1 Association between mental disorders and subsequent CVD10 ### The onset of CVD triggers mental disorders The onset of CVD escalates the risk of developing mental disorders by 2.2-fold. The 12-month prevalence of mental disorders in patients with CVD is reaching prevalence rates of 43.7% for inpatients and 42.2% for outpatients.12 These mental disorders are worsening cardiac prognosis significantly.5 13–15 For example, the most common symptoms of mental disorders, anxiety and …