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Title: The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease
Contributor(s): Tully, Phillip J  (author)orcid ; Cosh, Suzanne M  (author)orcid ; Baumeister, Harald (author)
Publication Date: 2014-12
Early Online Version: 2014-10-14
DOI: 10.1016/j.jpsychores.2014.10.001
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Abstract: Objective: To (1) report the prognostic association between anxiety disorder subtypes and major adverse cardiac events (MACE), (2) report anxiety disorder prevalence in coronary heart disease (CHD), and (3) report the efficacy of anxiety disorder treatments in CHD. Methods: A comprehensive electronic database search was performed in November 2013 for studies reporting anxiety disorder prevalence according to structured interview in CHD samples or MACE, and randomized controlled trials (RCTs) comparing anxiety disorder treatment with placebo or usual care. From 4041 articles 42 samples were selected for extraction (8 for MACE prognosis, 39 for prevalence, no RCTs were eligible). Results: Five generalized anxiety disorder (GAD) studies reported 883 MACE events (combined n = 2851). There was a non-significant association between GAD and MACE (risk ratio = 1.20, 95% CI .86-1.68, P = .28) however the effect size was highly significant in outpatient samples (adjusted hazard ratio = 1.94, 95% CI 1.45-2.60, P < .001). No other anxiety disorder subtype was associated with MACE. Prevalence data showed high comorbidity with depression (49.06%; 95% CI 34.28-64.01) and substantial heterogeneity between studies. Panic disorder prevalence was higher in psychiatrist/psychologist raters (9.92% vs. 4.74%) as was GAD (18.45% vs. 13.01%). Panic and GAD estimates were also heterogeneous according to DSM-III-R versus DSM-IV taxonomies. Conclusions: The paucity of extant anxiety disorder RCTs, alongside MACE risk for GAD outpatients, should stimulate further anxiety disorder intervention in CHD populations. Research should focus on depression and anxiety, thereby unraveling disorder specific and more generic pathways.
Publication Type: Journal Article
Grant Details: NHMRC/1053578
Source of Publication: Journal of Psychosomatic Research, 77(6), p. 439-448
Publisher: Elsevier Inc
Place of Publication: United States of America
ISSN: 0022-3999
Field of Research (FoR) 2008: 170106 Health, Clinical and Counselling Psychology
110201 Cardiology (incl. Cardiovascular Diseases)
Field of Research (FoR) 2020: 520302 Clinical psychology
520303 Counselling psychology
520304 Health psychology
320101 Cardiology (incl. cardiovascular diseases)
Socio-Economic Objective (SEO) 2008: 920410 Mental Health
Socio-Economic Objective (SEO) 2020: 200409 Mental health
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Psychology

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