Stress, psychiatric disorders, and cardiovascular disease

Well established links now exist between mood disorders such as depression and an increased risk of cardiovascular disease,1 and a large but somewhat contentious literature links anxiety disorders with cardiovascular disease.23 In contrast, data on the associations between other psychiatric disorders and cardiovascular disease are limited. In the linked paper (doi:10.1136/bmj.231),4 Song et al report on an elegant population based cohort study, including both sibling controlled and population matched designs exploring associations between acute psychiatric disorders induced by an acute stressful life event and cardiovascular disease.

In this large study (approximately 130 000 patients with a psychiatric disorder induced by acute stress, such as post-traumatic stress disorder (PTSD), acute stress reaction, or adjustment disorder; 170 000 full siblings without a disorder; and 1.4 million unexposed members of the general population) the authors found a consistent, significant …