Mental disorders among persons with heart disease - results from World Mental Health surveys

Johan Ormel, Michael Von Korff, Huibert Burger, Kate Scott, Koen Demyttenaere, Yue qin Huang, José Posada-Villa, Jean Pierre Lepine, Matthias C. Angermeyer, Daphna Levinson, Giovanni de Girolamo, Norito Kawakami, Elie Karam, María Elena Medina-Mora, Oye Gureje, David Williams, Josep Maria Haro, Evelyn J. Bromet, Jordi Alonso, Ron Kessler

Research output: Contribution to journalArticlepeer-review


Objectives: While depression and heart disease often co-occur in Western countries, less is known about the association of anxiety and alcohol use disorders with heart disease and about the cross-cultural consistency of this association. Consistency across emotional disorders and cultures would suggest that relatively universal mechanisms underlie the association. Methods: Surveys with 18 random population samples of household-residing adults in 17 countries in Europe, the Americas, the Middle East, Africa, Asia and the South Pacific were carried out. Medically recognized heart disease was ascertained by self-report. Mental disorders were assessed with the World Mental Health Composite International Diagnostic Interview, a fully structured diagnostic interview. Results: Specific mood and anxiety disorders occurred among persons with heart disease at rates higher than those among persons without heart disease. Adjusted for sex and age, the pooled odds ratios (95% confidence interval) were 2.1 (1.9-2.5) for mood disorders, 2.2 (1.9-2.5) for anxiety disorders and 1.4 (1.0-1.9) for alcohol abuse/dependence among persons with versus those without heart disease. These patterns were similar across countries. Conclusions: An excess of anxiety disorders and that of mood disorders are found among persons with heart disease. These associations hold true across countries despite substantial between-country differences in culture and mental disorder prevalence rates. These results suggest that similar mechanisms underlie the association and that a broad spectrum of mood-anxiety disorders should be considered in research on the comorbidity of mental disorders and heart disease.

Original languageEnglish
Pages (from-to)325-334
Number of pages10
JournalGeneral Hospital Psychiatry
Issue number4
Publication statusPublished - Jul 2007


  • Anxiety
  • Cross-national
  • Depression
  • Heart disease
  • Substance abuse

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)
  • Psychiatry and Mental health


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