Affective and anxiety disorders comorbid with heart disease: a review

Objective – To review the state of the art on research about heart and affective and anxiety disease to show possible new directions in research. Method – A literature search is carried out in MEDLINE about heart disease and psychiatric disorders. The attention has been focused on major depression, bipolar disorder, generalized anxiety disorder, panic disorder with and without agoraphobia, social phobia, obsessive-compulsive disorder, and posttraumatic stress disorder. Conclusions - Anxiety and affective disorders seem common in patients with a cardiovascular disease, but the results are contradictory and not exaustive about the underlying mechanism of such a comorbidity. Cardiovascular diseases occurring after a psychiatric disorder and the corresponding relationship have not been well investigated, excepted for the evaluation of role of the autonomic system dysregulation in both anxiety and affective disorders. Anxiety disorders, and particularly panic disorder, are independent risk factors for cardiovascular disease and death. Further investigations are necessary to improve the knowledge about the relationship between medical and psychiatric illnesses.