Cited by 201Cardiac Health and Mental HealthAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their Treatments

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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

Tully, Phillip J., Cosh, Suzanne M., Baumeister, Harald·2014·Journal of Psychosomatic Research

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.

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Authors: Tully, P. J., Cosh, S. M., & Baumeister, H.
Affiliations: University of Freiburg (DE)
Universität Ulm (DE)
Corresponding author: Tully, Phillip J.
ORCID: Tully, Phillip J.
Cosh, Suzanne M.
Baumeister, Harald
Venue: Journal of Psychosomatic Research
Publisher: Elsevier BV
Published: 2014-12
Volume: 77
Issue: 6
Pages: 439-448
ISSN: 0022-3999 (ISSN-L)
DOI: 10.1016/j.jpsychores.2014.10.001
OpenAlex: W1984444522
Cited by: 201
References: 97
Citations by year: 2026: 7 · 2025: 18 · 2024: 18 · 2023: 16 · 2022: 21 · 2021: 24 · 2020: 24 · 2019: 17 · 2018: 20 · 2017: 11 · 2016: 15 · 2015: 10
FWCI: 1.94
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Psychosomatic Research (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Figshare (submittedVersion)
RUNE (Research UNE) (submittedVersion)
Funders: National Health and Medical Research Council of Australia (1053578)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: anxiety disorders, coronary artery disease, generalized anxiety disorder, panic disorder, major adverse cardiac events, comorbid depression, anxiety disorder treatment, psychiatric comorbidity
MeSH terms: Anxiety, Anxiety Disorders, Coronary Artery Disease, Coronary Disease, Depression, Humans, Interview, Psychological, Predictive Value of Tests, Prognosis, Risk Factors, Comorbidity, Prevalence, Panic Disorder, Risk Assessment

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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

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