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Depression, anxiety can spike heart failure risk

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WASHINGTON — Experts from across the globe have said that there is a Pathophysiological relationship between heart failure and depression and anxiety.

According to the latest study by Harvard Review of Psychiatry, about one-third of people who have fallen into traps of depression and anxiety are at higher risk of progressive heart diseases.

Christopher Celano, MD, of Massachusetts General Hospital and colleagues were of the view that both anxiety and depression remain under-recognized and untreated in patients suffering from heart failure or cardiac attack.

He further said that at times, it becomes challenging for medical practitioners to identify the symptoms of heart failure as there is a significant overlap between psychiatric symptoms and those related to heart failure.

“Making the effort can help to identify those who are at higher risk for poor cardiac outcomes and to implement the treatment of these disorders,” Celano said.

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The victims of heart failure suffering from depression and anxiety also find it difficult to follow the recommended diet, exercise routine, and medication use. Studies have also linked depression to metabolic changes, including increased levels of inflammatory markers.

While conducting the study, the researchers found that one-third of people having heart failure have elevated symptoms of depression on standard questionnaires, while nineteen percent meet diagnostic criteria for major depression or other depressive disorders.

The study also revealed that even a healthy person suffering from mild depression is also likely to develop heart failure.

Notably, these researchers have raised the need for further research on effective treatments for the large group of people suffering from heart failure accompanied by depression and anxiety.

Celano and co-authors conclude, “It is likely that an aggressive, multimodal treatment approach – such as collaborative care models or stepped care from a mental health professional — will be needed to improve psychiatric and cardiac health in this high-risk population.”

The study appeared in the journal Harvard Review of Psychiatry.

ANI

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Suicide can’t be predicted by asking about suicidal thoughts : Study

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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