Anxiety disorders and post-traumatic stress disorder in patients with coronary heart disease

Anxiety and post-traumatic stress disorder (PTSD) are known etiologic and prognostic risk factors in patients with coronary heart disease (CHD). However, few studies have assessed the prevalence of a comprehensive set of anxiety and stress related disorders in CHD. Moreover, it is unclear whether these disorders are associated with CHD symptoms, severity and cardiovascular events and procedures. We determined the 12-month prevalence of anxiety disorders and PTSD in N = 1024 hospitalized patients with CHD and examined associations with cardiac disease characteristics, cardiovascular events and procedures. Anxiety and PTSD diagnoses were determined with the Composite International Diagnostic Interview. Socio-demographic variables were assessed with a questionnaire and cardiovascular variables were extracted from medical charts. 12-month prevalence for any anxiety disorder was 11.2% for men and 24.8% for women; 12-month PTSD prevalence was 1.1% and 5.2%, respectively. The most common anxiety disorders were specific phobia (men: 8.2%, women: 18.8%) and agoraphobia and/or panic disorder (combined prevalence men: 2.9%, women: 9.9%). Anxiety disorders were not associated with any cardiovascular variables. Due to lack of follow-up data no conclusions regarding stability of diagnoses are possible. Associations of PTSD and medical variables could not be determined because of low PTSD prevalence. Compared to the general population, anxiety disorders were more frequent in younger (<50) and middle-aged (50-64) women and middle-aged men with CHD. Reliable assessments of mental disorder prevalence in patients with CHD are the basis for improved patient care and prevention of adverse progression.