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10 Psychiatric Co-morbidities and Tendencies in Patients with Non-Ischaemic heart Failure (NIHF) – A Large Observational Cohort Study Spanning 14 Years
  1. D Rasoul1,
  2. Sam Wong2,
  3. Suresh Chandran3,
  4. Hardeep Uppal3,
  5. Jaydeep Sarma4,
  6. Rahul Potluri3
  1. 1The Royal Liverpool University Hospital
  2. 2Macclesfield District General Hospital
  3. 3ACALM Study Unit
  4. 4University Hospital of South Manchester NHS Foundation Trust

Abstract

Introduction Studies have shown that one in four psychiatric patients also suffer from a cardiovascular co-morbidity, and in recent years the links between cardiovascular disease and psychiatric conditions have been on the rise. We decided to investigate the prevalence of psychiatric co-morbidities and tendencies in patients with NIHF over a 14 year period.

Methods We compiled an anonymous database of adult patients diagnosed with NIHF across 7 hospitals in the North of England, UK, during 01/01/2000 to 31/03/2013. We analysed the data for prevalence of psychiatric co-morbidities such as; anxiety disorder, schizophrenia, depression etc. and for tendencies such as substance abuse and suicide attempts. We traced our patients with the ACALM (Algorithm for Co-morbidities, Associations, Length of Stay and Mortality) study protocol, which uses ICD-10 and OPCS-4 codes to allocate patients for statistical analysis using SPSS Version 20.0.

Results Between the years 2000–2013, 929,552 patients were admitted, 958 (0.1%) of which had NIHF. The majority of our patients where male (68%), had a mean age of 54.9 years ± 13.9 years, and had a Caucasian background (77%). Of these 958 patients, 8.1% (n = 78) had a psychiatric co-morbidity; depression and schizophrenia where most prevalent. Depression however, seems to more prevalent in dilated cardiomyopathy (DCM) as opposed to hypertrophic cardiomyopathy (HCM). 10.3% (n = 99) suffered from substance abuse, made up mainly by alcohol and tobacco abuse. 2 of our patients (0.2%) where admitted following suicide attempts.

Conclusion It remains debatable whether these psychiatric conditions and tendencies represent a causative or correlative link. Studies exists to lend evidence to both claims. We did however find a steady increase in tobacco and alcohol abuse, and the diagnosis of depression in relation to our cohort during our 14-year period. We found that almost one in ten (8.14%) patients with NIHF suffer from psychiatric co-morbidity and that one in ten (10.33%) abuse some form of substance alongside their cardiac condition. Thus, a holistic approach to patients with NIHF should be adopted, and this approach would fall short if it did not explore patient’s use of recreational drugs, suicidal intent and psychiatric wellbeing.

  • Dilated Cardiomyopathy
  • Hypertrophic Cardiomyopathy
  • Psychiatric comorbidities

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