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          Fear and Distress Disorders are Significantly Associated with Subsequent Heart Disease Risk

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          As on today only few studies have shown the associations of anxiety and depression with heart disease. These disorders can be grouped in fear and distress disorders. Aim of the current study was to evaluate the association between fear and distress disorders with subsequent heart disease, taking into account the temporal order of disorders

          A chain of surveys were conducted in 18 countries and enrolled a population of (n=53791; person years=2,212,430). The Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of disorders, and respondents were categorized into categories based on the presence and timing of fear and distress disorders. Heart disease was indicated by self-report of physician-diagnosed heart disease or self-report of heart attack, together with year of onset.

           

          Analysis of the results revealed that

          • Respondents with fear or distress disorders had either pure distress or pure fear (8.5% and 7.7% of total sample), while fear preceded distress in the large majority of respondents with comorbid fear and distress (3.8% of total sample).
          • In comparison with the "no fear or distress disorder" category, respondents with pure fear disorder had the highest odds of subsequent heart disease (OR:1.8; 95%CI:1.5-2.2; p<0.001) and compared to respondents with pure distress disorder, these respondents were at a significantly increased risk of heart disease (OR:1.3; 95%CI:1.0-1.6; p=0.020).
          • Furthermore the sensitivity analysis that examines the association between pure PD/Posttraumatic stress disorder (PTSD) and pure phobia with subsequent heart disease reported both pure PD/ PTSD (OR: 1.9; 95% CI: 1.5–2.5) and pure phobia (OR: 1.6; 95% CI:1.4–1.8) were significantly related to heart disease (see Table 4). 

          It is found that pure fear disorder is associated significantly more with risk of heart disease when compared to distress disorder. These results should be confirmed in prospective studies using objective measures of heart disease.

          Roest AM, De jonge P, Lim CWW, et al. Fear and distress disorders as predictors of heart disease: A temporal perspective. J Psychosom Res. 2017;96:67-75.


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