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Cardiovascular diseases and psychiatric disorders in the general population: a prospective follow-up study

English title Cardiovascular diseases and psychiatric disorders in the general population: a prospective follow-up study
Applicant Preisig Martin
Number 139468
Funding scheme Cohort Studies Large
Research institution Dépt. Universitaire de Psychiatrie Adulte Département de Psychiatrie CHUV
Institution of higher education University of Lausanne - LA
Main discipline Mental Disorders, Psychosomatic Diseases
Start/End 01.04.2012 - 31.03.2014
Approved amount 1'922'000.00
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All Disciplines (3)

Discipline
Mental Disorders, Psychosomatic Diseases
Metabolic Disorders
Cardiovascular Diseases

Keywords (6)

Mental disorders; Cardiovascular risk factors; Cardiovascular diseases; Epidemiology; Genetics; Public health

Lay Summary (English)

Lead
Lay summary

Background: Cardio-vascular diseases (CVD), their well established risk factors (CVRF) and mental disorders are common and co-occur more frequently than would be expected by chance. However, the pathogenetic mechanisms and course determinants of both CVD and mental disorders have only partially been identified. In particular, the mechanisms underlying their association still need to be elucidated. Several non-mutually exclusive hypotheses have been suggested to explain this association: a) mental disorders could increase vulnerability to CVD through damaging health behavior including smoking, poor diet, sedentary lifestyle or the side effects of psychotropic drugs; b) CVD or its treatment could promote the development of mental disorders; or c) mental disorders and CVD/CVRF could share pathogenetic mechanisms, such as metabolic processes or genes.

The primary aim of the cohort proposal is to follow-up a large population-based sample, which underwent a comprehensive somatic, psychiatric and genetic investigation in order to prospectively assess the complex association between CVD, CVRF and mental disorders.

Data collection at follow-up surveys will include: 1) the course of the conditions related to CVD or mental disorders observed at baseline; 2) the incidence of conditions related to CVD or mental disorders during the follow-up; 3) supplementary data on relevant phenotypes that were not part of the baseline investigation; and 4) the evaluation of candidate variables which could be either mediators of a causal relationship or shared factors underlying the association between mental disorders and CVD/CVRF. This list includes biological (genetic, inflammatory, hormonal), clinical (persistent pain, sleep disorders), behavioral (nutrition, physical activity, smoking, alcohol and drug consumption, coping style) and environmental factors (major life-events, social support). The collection of this follow-up information is crucial for the establishment of the dynamic relationship between CVD/CVRF and mental disorders. Specifically, it will allow us to address:

Three main study questions: 1) Do mental disorders increase vulnerability to CVRF and CVD? 2) Do CVRF and CVD or their drug treatment promote the development of mental disorders? 3) Do CVRF/CVD and mental disorders share common pathogenetic processes?

Methods: The project combines a comprehensive follow-up of CVRF and CVD with a psychiatric exam in all subjects of the original CoLaus sample (n = 6'738). The somatic investigation includes a shortened questionnaire on CVRF, CV events and new CVD since baseline and measurements of the same clinical and biological variables in the fasting state as at baseline. Data on the cause of death will be collected from the Swiss National Death Registry. The comprehensive psychiatric investigation employs contemporary epidemiological methods. In addition, screening for subjective and objective cognitive impairment is performed in subjects older than 65 years. This first follow-up of the sample has started in 2009 and is progressing rapidly. We expect that by spring 2013, 5000 subjects will have participated at the physical and 4000 subjects at the psychiatric evaluation.

Major achievements: Analyses of the data from the baseline evaluations and the recently assessed cytokines have yielded more than 80 papers in high impact factor peer-reviewed scientific journals. A first set of epidemiological articles have provided highly relevant results from the public health perspective, whereas a second set of articles, based on genetic data (GWAS), have contributed, in combination with data from other studies, to a better insight into potential new determinants involved in the pathogenesis of complex diseases.

Expected value of the project: The combined CoLaus/PsyCoLaus sample provides a unique opportunity to obtain prospective data on the interplay between CVRF/CVD and mental disorders, overcoming limitations of previous research by bringing together a comprehensive investigation of both CVRF and mental disorders as well as a large number of biological variables and a genome-wide genotype assessment in subjects recruited from the general population. With the recent rapid progress in identifying genetic markers for complex diseases, we anticipate that numerous genetic markers for the index diseases in this study will also be used to inform us on the mechanisms of the associations between CVD/CVRF and mental disorders, as well as to predict risk for the development of these conditions.. A better understanding of the psychological, physiological and behavioral links underlying these conditions will result in the development of more specific and efficient strategies of prevention and treatment for both psychiatric and CVD/CVRF, two major elements of burden of disease.

Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Name Institute

Associated projects

Number Title Start Funding scheme
148401 Cardiovascular diseases and psychiatric disorders in the general population: a prospective follow-up study 01.04.2014 Cohort Studies Large
140960 A Randomized-Controlled Minimal Early Behavioral Intervention Trial to Prevent the Development of Posttraumatic Stress Caused by Acute Myocardial Infarction 01.10.2012 Project funding (Div. I-III)
171352 Age-related renal function decline: a comprehensive study using metabolomic analysis 01.05.2017 Marie Heim-Voegtlin grants
144064 Etude pharmacogenetique sur les effets secondaires induits par les médicaments psychotropes 01.01.2013 Project funding (special)
186203 Age-related renal function decline: a comprehensive study using metabolomic analysis 01.05.2019 Marie Heim-Voegtlin grants
122661 Cardiovascular diseases and psychiatric disorders in the general population: a prospective follow-up study 01.01.2009 Cohort Studies Large

Abstract

Background: The mechanisms underlying the frequent co-occurrence of cardio-vascular diseases (CVD) or risk factors (CVRF) and mental disorders still need to be elucidated. The primary aim of the cohort proposal is to follow-up a large population-based sample, which underwent a comprehensive somatic, psychiatric and genetic investigation in order to prospectively assess the complex association between CVD, CVRF and mental disorders. The collection of this follow-up information will allow us to address:Three main study questions: 1) Do mental disorders increase vulnerability to CVRF and CVD? 2) Do CVRF and CVD or their drug treatment promote the development of mental disorders? 3) Do CVRF/CVD and mental disorders share common pathogenetic processes?Methods: The proposal combines a comprehensive follow-up of CVRF and CVD with a psychiatric exam in all subjects of the original CoLaus sample of 6'733 subjects (age range 35 to 75 years; 3’717 with both a somatic and psychiatric evaluation). Except for minor changes in the psychiatric self-ratings and in the screening of cognitive diseases, the methodology of the study is identical to that described in the initial proposal. In the somatic investigation, information is collected on the incidence of CVRF or CVD since baseline and on the course of CVRF present at baseline. In addition, pro-inflammatory markers are assessed and data are gathered on dietary habits, physical activity, persistent pain and sleep characteristics. In the case of a new CV event, detailed information is elicited from medical records. Similarly, data on the cause of death are collected from the Swiss National Death Registry. The psychiatric investigation (follow-up version of the DIGS interview) collects information on psychopathological manifestations, psychotherapeutic interventions and the success and side effects of drug treatment during the follow-up period. In addition, the diurnal salivary cortisol profile is determined and a screening for cognitive impairment is performed in subjects older than 65 years. Description of the multicentric character of the cohort study: Although data collection is limited to one geographic region, the analyses of the follow-up data is shared by the different research groups at the four Swiss centers of Lausanne, Geneva, Bern and Zurich as well as by international collaborating centers according to the specific expertise of each group. Two meetings of the Scientific Advisory Board including all investigators as well as the international experts took place in November 2009 and 2010.Major achievements: Recruitment for follow-up evaluations is progressing rapidly and follows the prospected schedule: 4’808 subjects have participated in the somatic evaluation or have already agreed to participate and are scheduled for the next weeks, whereas 2.2% of subjects died and 3.0% have left Switzerland. Participation rate is 92% among individuals who have undergone both the somatic and psychiatric evaluations at baseline and 80% for the whole sample. Regarding the psychiatric evaluation, which started one year after the somatic evaluation, 1’630 subjects have completed this assessment. The participation rate of 81% is significantly higher than expected with 90% participation among subjects who have undergone both the somatic and psychiatric baseline investigations. Analyses of the data from the baseline evaluations and the recently assessed cytokines have yielded more than 80 papers in high impact factor peer-reviewed scientific journals. A first set of epidemiological articles provided highly relevant results from the public health perspective, whereas a second set of articles, based on GWAS data, have contributed, in combination with data from other studies, to a better insight into potential new determinants involved in the pathogenesis of complex diseases.Major challenges and developments over the next two years: The goals and milestones of the next two years will include the completion of data collection from the first follow-up and data analysis. The physical follow-up will be completed by March 31, 2012 (n=approximately 5’375). The psychiatric follow-up will be completed by March 31, 2013 (n=approximately 4’350). Analyses and publications of baseline data will continue until follow-up data will be available. Analyses involving physical follow-up data will start in 2012, whereas those involving associations between physical and psychiatric data will start in 2013.
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