Risks for anxiety and suicide attempt may increase after hospital stay for heart disease, stroke

Being hospitalized for cardiovascular disease – including several types of heart disease and stroke – may significantly raise the risk for anxiety, depression and suicide attempts, especially in the year that follows, new research suggests.

The study, published Wednesday in the Journal of the American Heart Association, found people who were hospitalized for cardiovascular-related conditions were 83% more likely to be diagnosed with psychiatric issues within a year of hospitalization than people free of cardiovascular disease, regardless of any genetic susceptibilities to psychiatric conditions.

"It's crucial to pay attention to both physical and mental health after a stroke or heart disease diagnosis," senior study author Dr. Huan Song said in a news release. Song is a professor of epidemiology at Sichuan University in Chengdu, China.

"If you or a loved one has been hospitalized for heart disease, be aware that mental health issues may arise during recovery," Song said. "It's important to monitor for signs of anxiety, depression or suicidal thoughts. These mental health challenges are common and treatable."

Prior research has found a higher risk of psychiatric disorders – such as anxiety, depression and post-traumatic stress disorder – among people with cardiovascular disease. But most of these studies did not include large populations or account for environmental and lifestyle factors.

In the new study, researchers analyzed genetic, physical and health data for two groups of people in the UK Biobank, a biomedical database of about half a million people in the United Kingdom. They compared data for 63,923 people hospitalized for a cardiovascular condition between 1997 and 2020 to similar data for 127,845 matched adults without cardiovascular disease. Researchers wanted to know how lifestyle and environmental factors affected short- and long-term risk for psychiatric disorders and whether genetic susceptibility played a role.

Cardiovascular disease was defined as ischemic heart disease, cerebrovascular disease or stroke, blood clots, heart failure, irregular heart rhythms and other heart conditions. Participants were a median age of 63. Median follow-up was about 7 1/2 years. Researchers looked at how often participants developed anxiety, depression, a stress-related disorder, substance misuse, a psychotic disorder or suicide behaviors.

The risk for multiple psychiatric conditions significantly increased following hospitalization for cardiovascular disease, especially during the first year, regardless of genetic susceptibility. Participants were 83% more likely to be diagnosed with a psychiatric disorder within one year of hospital admission. The biggest increases in risk were for anxiety, depression and suicide behaviors, such as self-harm or suicide attempts.

The risk lessened but did not disappear after the first year. People hospitalized for cardiovascular disease remained 24% more likely to be diagnosed with a psychiatric disorder. Those who had a stroke and other cerebrovascular disease had a more than threefold higher risk for psychiatric disorders and suicide attempts within the first year of hospital admission and a 49% higher risk after one year.

People who have suicidal thoughts should contact emergency services, go to the nearest emergency room, dial 988 for the 988 Suicide & Crisis Lifeline or contact local mental health crisis services, Song said.

"Patients should tell their health care professional about any mental health symptoms," Song said. "They can provide support, refer you to a mental health specialist or adjust your treatment plan. Reach out to a therapist, counselor or psychiatrist for help if you're struggling with your mental health, or share your feelings with family members, friends or a support group to gain emotional support and help you navigate the challenges you're facing."