Browsing by Author "Sawhney, Manisha"

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    Atypical depression and double depression predict new-onset cardiovascular disease in U.S. adults
    (Wiley, 2018-01) Case, Stephanie M.; Sawhney, Manisha; Stewart, Jesse C.; Psychology, School of Science
    BACKGROUND: Although depression is a risk factor for cardiovascular disease (CVD), it is unknown whether this risk varies across depressive disorder subtypes. Thus, we investigated atypical major depressive disorder (MDD) and double depression as predictors of new-onset CVD in a nationally representative sample of U.S. adults. METHODS: Prospective data from 28,726 adults initially free of CVD who participated in Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Lifetime depressive disorder subtypes (Wave 1) and incident CVD (Wave 2) were determined by structured interviews. RESULTS: We identified 1,116 incident CVD cases. In demographics adjusted models, the atypical MDD group had a higher odds of incident CVD than the no depression history (OR = 2.19, 95% CI: 1.71-2.81, P < .001), dysthymic disorder only (OR = 1.61, 95% CI: 1.08-2.39, P = .019), and nonatypical MDD (OR = 1.46, 95% CI: 1.11-1.91, P = .006) groups. Likewise, the double depression group had a higher odds of incident CVD than the no depression history (OR = 2.17, 95% CI: 1.92-2.45, P < .001), dysthymic disorder only (OR = 1.59, 95% CI: 1.16-2.19, P = .004), and MDD only (OR = 1.46, 95% CI: 1.20-1.77, P < .001) groups. Relationships were similar but attenuated after adjustment for CVD risk factors and anxiety disorders. CONCLUSIONS: Adults with atypical MDD or double depression may be subgroups of the depressed population at particularly high risk of new-onset CVD. Thus, these subgroups may (a) be driving the overall depression-CVD relationship and (b) be in need of earlier and/or more intense CVD primary prevention efforts to reduce their excess CVD burden.
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    Double Depression is Associated with Greater Risk of Incident Cardiovascular Disease than Major Depression: Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
    (Office of the Vice Chancellor for Research, 2013-04-05) Case, Stephanie M; Sawhney, Manisha; Stewart, Jesse C
    Evidence suggests depressive disorders are risk factors for cardiovascular disease (CVD), however, little attention has been given to double depression (major depressive disorder (MDD) superimposed on dysthymia). The current study sought to determine if double depression is a stronger predictor of incident CVD due to greater duration of exposure and severity of depression in adults initially free of CVD. We analyzed data from 29,581 adults (mean age = 45 years, 58% female, 42% non-white) from Waves 1 (2001-2002) and 2 (2004-2005) of the NESARC study. At Wave 1, the Alcohol Use Disorder and Associated Disabilities Interview Schedule was administered to assess lifetime history of DSM-IV MDD and/or dysthymia. A 4-level variable was created for depression: no depression history (n=24,339), lifetime MDD only (n=4,028), lifetime dysthymia only (n=246), lifetime MDD and dysthymia (double depression; n=968). At Wave 2, participants who reported being diagnosed with myocardial infarction, stroke, angina, or arteriosclerosis in the past year were coded as having incident CVD; those diagnosed with myocardial infarction or stroke were coded as having had a hard CVD event. There were 1,380 CVD events and 365 hard CVD events. Logistic regression models adjusted for demographics (age, sex, race-ethnicity, education) and CVD risk factors (hypertension, hypercholesterolemia, diabetes, smoking, BMI) revealed that lifetime double depression (OR=1.72, 95% CI: 1.31-2.25, p<.001) and MDD only (OR=1.26, 95% CI: 1.06-1.49, p=.01), but not dysthymia only (OR=1.45, 95%, CI: 0.88-2.40, p=.15), predicted incident CVD. Double depression was a stronger predictor than MDD only (p=.04). In models predicting hard CVD events, double depression remained a predictor (OR=1.86, 95% CI: 1.10-3.16, p=.02) but MDD and dysthymia only did not (both ps>.43). Our findings partially support our hypothesis and suggest that persons with double depression may have a stronger connection to an elevated CVD risk in which prevention efforts should be intensified.