Major psychiatric disorders and the aetiology and progression of coronary heart disease

Cardiovascular disease (CVD) and major psychiatric disorders (MPD) are among the leading causes of death and disability worldwide, underscoring the importance of prevention and intervention. It is estimated that by 2020, CVD and depression will be the leading causes of death and disability worldwide, highlighting these conditions as a serious public health issue ( Murray and Lopez, 1996 ). This article provides an overview of MPD as a risk factor for the development and progression of CVD. Specifically, this paper summarises key empirical work regarding the aetiological and prognostic risk of CVD posed by MPD (as defined on AXIS I of the Diagnostic and Statistical Manual (DSM) such as major depressive disorders, both unipolar and bipolar; anxiety disorders including generalised anxiety, panic disorder, phobia and post-traumatic stress disorder; schizophrenia and other psychoses; adjustment disorder; and substance use disorders. Potential mechanisms are discussed, with attention to both physiological and behavioural pathways. Effective treatments are reviewed and clinical implications of the relationship between CVD and MPD are also discussed.