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Comorbid cardiovascular disease and major depression among ethnic and racial groups in the United States

Published online by Cambridge University Press:  07 January 2013

Hector M. González*
Affiliation:
Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan, USA Program for Research on Black Americans, Institute of Social Research, University of Michigan, Michigan, USA
Wassim Tarraf
Affiliation:
Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
*
Correspondence should be addressed to: Hector M. González, Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, 87 East Ferry Street, 226 Knapp Building, Detroit, Michigan 48202, USA. Phone: (313) 577-2297; Fax: (313) 875-0127. Email: [email protected].

Abstract

Background: To describe and examine the distribution, disability, and treatment associated with comorbid cardiovascular disease and major depressive disorder (CVD/MDD) among middle-aged and older ethnic/racial groups in the United States.

Methods: Cross-sectional data from a national probability sample of household resident adults (18 years and older; N = 16,423) living in the 48 coterminous United States were analyzed. We defined comorbid CVD/MDD as the presence of CVD (e.g. diabetes, hypertension, heart disease, and stroke) among adults who met MDD criteria at or after age 50 years.

Results: Two-thirds of middle-aged and older American adults meeting criteria major depression at or after age 50 years also reported a diagnosis of comorbid CVD. Blacks were most likely to meet our comorbid CVD/MDD (74.4%) criteria. The disease burden of depression was also highest among Black respondents. Differences in treatment due to race/ethnicity and comorbidity were not statistically significant.

Conclusions: Our findings indicate that among middle-aged and older US adults meeting MDD criteria more than half would also report a comorbid CVD. Comorbid CVD/MDD rates varied between the considered ethnic/race groups. Functional impairment associated with comorbid CVD/MDD was higher than MDD alone; however, depression care rates did not differ remarkably. Among middle-aged and older adults meeting MDD criteria, comorbid CVD may be the rule rather than the exception.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013

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References

Alexopoulos, G. S. (2006). The vascular depression hypothesis: 10 years later. Biological Psychiatry, 60, 13041305.CrossRefGoogle ScholarPubMed
American Psychiatric Association (APA) (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, revised. Washington, DC: American Psychiatric Association.Google Scholar
Cameron, C. A. and Trivedi, P. K. (2010). Microeconometrics Using Stata. (Revised Edition), College Station, Texas, USA: Stata Press.Google Scholar
Cutler, J. A., Sorlie, P. D., Wolz, L., Thom, T., Fields, L. E. and Roccella, E. J. (2008). Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension, 52, 818827.CrossRefGoogle ScholarPubMed
Flegal, K. M., Carroll, M. D., Kit, B. K. and Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA, 307, 491497.CrossRefGoogle ScholarPubMed
Frasure-Smith, N., Lesperance, F. and Talajic, M. (1993). Depression following myocardial infarction. Impact on 6-month survival. JAMA, 270, 18191825.CrossRefGoogle ScholarPubMed
George, L. K. (1994). Diagnosis and treatment of late life depression. In Schneider, L. S., Friedhoff, A. J., Reynolds, C. F. and Lebowitz, B. D. (eds.), Depression In Late Life (pp. 131153). Washington, DC: American Psychiatric Publishing.Google Scholar
González, H. M., Tarraf, W., Whitfield, K. E. and Vega, W. A. (2010). The epidemiology of major depression and ethnicity in the United States. Journal of Psychiatric Research, 44, 10431051.CrossRefGoogle ScholarPubMed
Goodwin, R. D., Davidson, K. W. and Keyes, K. (2009). Mental disorders and cardiovascular disease among adults in the United States. Journal of Psychiatric Research, 43, 239246.CrossRefGoogle ScholarPubMed
Hartley, H. O. (1974). Multiple frame methodology and selected applications. Sankhya, Series C, 36, 99118.Google Scholar
Heeringa, S. G., Wagner, J., Torres, M., Duan, N., Adams, T. and Berglund, P. (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research, 13, 221240.CrossRefGoogle Scholar
Katon, W. (1996). The impact of major depression on chronic medical illness. General Hospital Psychiatry, 18, 215219.CrossRefGoogle ScholarPubMed
Kessler, R. C.et al. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289, 30953105.CrossRefGoogle ScholarPubMed
Krishnan, K. R. and McDonald, W. M. (1995). Arteriosclerotic depression. Medical Hypotheses, 44, 111115.CrossRefGoogle ScholarPubMed
Pennell, B. E.et al. (2004). The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. International Journal of Methods in Psychiatric Research, 13, 241269.CrossRefGoogle ScholarPubMed
Roger, V. L.et al. (2011). Heart disease and stroke statistics—2011 update. Circulation, 123, e18e209.CrossRefGoogle ScholarPubMed
Steffens, D. C., Bosworth, H. B., Provenzale, J. M. and MacFall, J. R. (2002). Subcortical white matter lesions and functional impairment in geriatric depression. Depression and Anxiety, 15, 2328.CrossRefGoogle ScholarPubMed
Whyte, E. M. and Mulsant, B. H. (2002). Post-stroke depression: epidemiology, pathophysiology, and biological treatment. Biological Psychiatry, 52, 253264.CrossRefGoogle ScholarPubMed
Williams, D. R.et al. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: results from the National Survey of American Life. Archives of General Psychiatry, 64, 305315.CrossRefGoogle ScholarPubMed
World Health Organization (WHO) (2001). World Health Organization Disability Assessment Schedule II (WHODAS II). Geneva: World Health Organization.Google Scholar