Mental disorders and cardiovascular disease among adults in the United States

J Psychiatr Res. 2009 Jan;43(3):239-46. doi: 10.1016/j.jpsychires.2008.05.006. Epub 2008 Jul 9.


Objective: Numerous population-based studies have found an association between major depression and CVD, though these studies did not assess anxiety disorders. Patient samples have shown associations between anxiety disorders and cardiovascular disease (CVD), but without consideration of depressive disorders. Therefore, it remains unclear whether: (a) both anxiety and depressive disorder are associated with CVD; (b) these associations are generalizable to adults in the community.

Materials and methods: Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 43,093 civilian non-institutionalized participants aged 18 and older.

Results: CVD (total prevalence 3.3%) was associated with increased likelihood of any anxiety disorder (OR=1.43, (1.20, 1.71)), after adjusting for depressive disorders, as well as Generalized Anxiety Disorder (OR=1.48 (1.09, 2.01)), Panic disorder (OR=1.46 (1.12, 1.91)), and specific phobia (OR=1.29 (1.04, 1.59)). CVD was significantly associated with any mood disorder (OR=1.34 (1.13, 1.58)) after adjusting for anxiety disorders, though neither the link with major depression, nor other specific mood disorders remained significant after adjustment.

Conclusions: Our findings suggest that anxiety disorders, mood disorders, and CVD are highly comorbid among adults in the United States, and demonstrate the importance of including anxiety disorder assessment in studies of mental and physical comorbidity. These results reveal how the lack of investigation into specific relationships between CVD and the range of mental disorders in population-based studies of risk factors for CVD may obscure important relationships.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / epidemiology*
  • Cardiovascular Diseases / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Mood Disorders / epidemiology*
  • Panic Disorder / epidemiology
  • Phobic Disorders / epidemiology
  • Prevalence
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Substance-Related Disorders / epidemiology
  • United States / epidemiology
  • Young Adult