1
|
Liu T, Wang L, Zhu Z, Wang B, Lu Z, Pan Y, Sun L. Association of both depressive symptoms scores and specific depressive symptoms with all-cause and cardiovascular disease mortality. Ann Gen Psychiatry 2024; 23:25. [PMID: 39010080 PMCID: PMC11250981 DOI: 10.1186/s12991-024-00509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The presence of depression related to an increased risk of all-cause and cardiovascular disease (CVD) mortality has been reported. However, studies conducted on certain specific depressive symptoms are scarce. Our purpose was to assess the effect of both depressive symptoms scores and certain specific depressive symptoms on all-cause and CVD mortality. METHODS In the present cohort study, all participants, aged 18 years or older, were enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014. Depressive symptoms score was assessed using the validated 9-item Patient Health Questionnaire Depression Scale (PHQ-9), which ranges from 0 to 27, with a PHQ-9 score ≥ 10 diagnosed as depression. The outcome events were all-cause and CVD mortality, which were followed up from 2005 to 2014. The associations of both depressive symptoms score and certain specific depressive symptoms with all-cause and CVD mortality were examined by weighted multivariable proportional hazards models. RESULTS A total of 26,028 participants aged ≥ 18 years were included in the statistical analysis, including 12,813 (49.2%) males and 13,215 (50.8%) females, with a mean (SD) age of 47.34 (18.86) years. During the 9.32 (3.20) years of mean (SD) follow-up, 3261 deaths were recorded, of which 826 were cardiovascular deaths. All-cause mortality was 16.87/1000 person-years in subjects with depression. In terms of CVD mortality, these figures were 4.53/1000 person-years. In the full model (model 3), elevated depressive symptoms scores were independently associated with an increased risk of all-cause mortality (Highest depression symptom score group: adjusted hazard ratio, 1.63; 95% CI 1.44-1.85) and CVD mortality (Highest depression symptom score group: adjusted hazard ratio, 1.73; 95% CI 1.34-2.24). All 9 specific depressive symptoms that make up the PHQ-9 were related to an increased risk of all-cause mortality. However, only 3 symptoms, including trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation, were no significantly associated with an increased risk of CVD mortality. CONCLUSIONS The elevated depressive symptoms scores were strongly associated with an increased risk of all-cause and CVD mortality in US adults. Furthermore, all 9 specific depressive symptoms were associated with high all-cause mortality. However, trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation might not increase the risk of CVD mortality.
Collapse
Affiliation(s)
- Tao Liu
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Lili Wang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhijian Zhu
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Bing Wang
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Zhigang Lu
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yesheng Pan
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Lifang Sun
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| |
Collapse
|
2
|
Kerr WT, Patterson EH, O'Sullivan IM, Horbatch FJ, Darpel KA, Patel PS, Robinson-Mayer N, Winder GS, Beimer NJ. Elevated Mortality Rate in Patients With Functional Seizures After Diagnosis and Referral. Neurol Clin Pract 2024; 14:e200227. [PMID: 38223352 PMCID: PMC10783975 DOI: 10.1212/cpj.0000000000200227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/03/2023] [Indexed: 01/16/2024]
Abstract
Background and Objectives To evaluate the standardized mortality ratio (SMR) of patients in the United States referred to a multidisciplinary clinic for treatment of functional seizures. Methods We identified patients who had or had not died based on automated retrospective review of electronic health records from a registry of patients referred to a single-center multidisciplinary functional seizures treatment clinic. We calculated an SMR by comparing the number of observed deaths with the expected number of deaths in an age-matched, sex-matched, and race-matched population within the same state, and year records were available. Results A total of 700 patients with functional seizures (mean age 37 years, 78% female) were followed up for 1,329 patient-years for a median of 15 months per patient (interquartile range 6-37 months). We observed 11 deaths, corresponding to a mortality rate of 8.2 per 1,000 patient-years and an SMR of 2.4 (95% confidence interval: 1.17-4.22). Five of 9 patients with identified circumstances around their death were in hospice care when they passed. None of the identified causes of death were related to seizures directly. Discussion These data provide further evidence of elevated mortality in functional seizures soon after diagnosis and referral to treatment. These data from the decentralized health care system of the United States build on the findings from other countries with large-scale health registries.
Collapse
Affiliation(s)
- Wesley T Kerr
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Elissa H Patterson
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Isabel M O'Sullivan
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Faith J Horbatch
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Kyle A Darpel
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Palak S Patel
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Najda Robinson-Mayer
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Gerald S Winder
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| | - Nicholas J Beimer
- Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI
| |
Collapse
|