Abstract
BACKGROUND: Individuals with serious mental illness have a markedly shorter life expectancy. A major contributor to premature death is cardiovascular disease (CVD). We investigated associations of (genetic liability for) depressive disorder, bipolar disorder and schizophrenia with a range of CVD traits and examined to what degree these were driven by important confounders.
METHODS: We included participants of the Dutch Lifelines cohort ( N = 147 337) with information on self-reported lifetime diagnosis of depressive disorder, bipolar disorder, or schizophrenia and CVD traits. Employing linear mixed-effects models, we examined associations between mental illness diagnoses and CVD, correcting for psychotropic medication, demographic and lifestyle factors. In a subsample ( N = 73 965), we repeated these analyses using polygenic scores (PGSs) for the three mental illnesses.
RESULTS: There was strong evidence that depressive disorder diagnosis is associated with increased arrhythmia and atherosclerosis risk and lower heart rate variability, even after confounder adjustment. Positive associations were also found for the depression PGSs with arrhythmia and atherosclerosis. Bipolar disorder was associated with a higher risk of nearly all CVD traits, though most diminished after adjustment. The bipolar disorder PGSs did not show any associations. While the schizophrenia PGSs was associated with increased arrhythmia risk and lower heart rate variability, schizophrenia diagnosis was not. All mental illness diagnoses were associated with lower blood pressure and a lower risk of hypertension.
CONCLUSIONS: Our study shows widespread associations of (genetic liability to) mental illness (primarily depressive disorder) with CVD, even after confounder adjustment. Future research should focus on clarifying potential causal pathways between mental illness and CVD.
| Original language | English |
|---|---|
| Pages (from-to) | 931 - 939 |
| Number of pages | 9 |
| Journal | Psychological Medicine |
| Volume | 54 |
| Issue number | 5 |
| Early online date | 14 Sept 2023 |
| DOIs | |
| Publication status | Published - 1 Apr 2024 |
Bibliographical note
Funding Information:The Lifelines initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen). K. J. H. V., A. A. and J. L. T. are supported by the Foundation Volksbond Rotterdam. J. L. T. is supported by a Young Investigator (NARSAD) Grant from the Brain & Behaviour Research Foundation. Specifically, the current work was made possible by the Evelyn Toll Family Foundation. J. L. T. and R. R. V. are supported by a Senior Scientist Dekker Grant from the Dutch Heart Foundation (project number 03-004-2022-0055). M. R. M. is a member of the MRC Integrative Epidemiology Unit at the University of Bristol (MC_UU_00011/7), and the National Institute for Health Research (NIHR) Biomedical Research Centre at the University Hospitals Bristol National Health Service (NHS) Foundation Trust, and the University of Bristol.
Publisher Copyright:
Copyright © The Author(s), 2023. Published by Cambridge University Press.
