Key result
A combined diagnosis of cancer and heart disease was independently associated with a significantly higher likelihood of serious mental illness (OR 2.57).
Why the study?
Depression and anxiety in patients with heart disease and/or cancer affect quality of life, adherence, and prognosis, but the association of these diagnoses with serious mental illness required investigation.
Does having both heart disease and cancer increase the risk of serious mental illness in adults?
Cross-Sectional (n=24,777)
Does having both heart disease and cancer increase the risk of serious mental illness in adults?
Patients with a combined diagnosis of cancer and heart disease have a significantly higher likelihood of self-reporting serious mental illness compared to those with either diagnosis alone, highlighting the need for mental health screening in cardio-oncology patients.
May warrant mental health screening in patients with cancer and heart disease; hypothesis-generating and requires prospective confirmation.
Mina M. Benjamin MDa* , Robert Bossarte PhDb, Avirup Guha MDc , Mahek Shah MDd & Brijesh Patel DOaa Department of Cardiology, West Virginia Heart and Vascular Institute, Morgantown, West Virginiab Injury Control Research Center, West Virginia University, Morgantown, West Virginiac Division of Cardiovascular Medicine, Case Western University, Cleveland, Ohiod Department of Cardiovascular Medicine, Thomas Jefferson University, Philadelphia, PennsylvaniaSupplemental material for this article can be accessed at https://doi.org/10.1080/08998280.2020.1799736.None of the authors report relevant conflicts of interest pertinent to this study.Corresponding author: Mina M. Benjamin, MD,Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr., Morgantown, WV 26506 (e-mail: minamehannimd@gmail.com)AbstractDepression and anxiety in patients with heart disease and/or cancer have been shown to affect quality of life, adherence with medical management, and prognosis. We investigated the association of the diagnoses of cancer, heart disease, or both with self-reported symptoms consistent with serious mental illness (SMI). We used the K6 score to identify self-reported symptoms consistent with SMI from patients’ responses to the 2017 National Health Interview Survey. Our final cohort included 24,777 individual surveys. Of those respondents, 1509 reported cancer, 2639 reported heart disease, and 534 reported both. About 96% of patients reported a K6 score <13, and 4% reported a K6 score ≥13, which is suggestive of SMI. Logistic regression identified significant associations between SMI and an inability to afford mental care/counseling, an inability to afford prescribed medications, and unemployed status, with odds ratios of 6.97, 2.94, and 3.49, respectively. Having both heart disease and cancer was independently associated with SMI (odds ratio = 2.57; 95% confidence interval, 1.53–4.31; P < 0.001). In conclusion, in a nationally representative self-reported questionnaire, patients with a combined diagnosis of cancer and heart disease were significantly more likely to report SMI than those with either diagnosis alone.
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Benjamin et al. (2020) conducted a cross-sectional in Heart disease and/or cancer (n=24,777). Combined diagnosis of heart disease and cancer vs. No combined diagnosis was evaluated on Serious mental illness (SMI) defined as a K6 score ≥13 (OR 2.57, 95% CI 1.53-4.31, p=<0.001). A combined diagnosis of cancer and heart disease was independently associated with a significantly higher likelihood of serious mental illness (OR 2.57).
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