The influence of psychiatric disorders on heart failure

The aging population in Europe and the increased longevity have led to a higher prevalence of chronic heart failure. This is characterized by frequent hospitalizations, increased morbidity and high mortality rates, which all lead to a greater health burden. People who suffer from severe mental illnesses, such as schizophrenia, bipolar disorder and major depression, have a significant cardiovascular risk, due to their cardiovascular behaviors and conditions, which lead to a mortality rate twice as high as the one in the general population. Besides, people suffering from chronic or acute cardiovascular diseases can develop psychiatric disorders. The mechanisms by which psychiatric disorders can lead to heart failure are hypercortisolemia, a weakened response to pro-adrenocorticotropic hormone-releasing factor, the activation of platelet function, acute stress, cardiac arrhythmias and endothelial dysfunction, the activation of mechanisms leading to atherosclerosis, an increased inflammatory response etc. It has been noted that, after checking the risk factors, patients with heart failure and severe mental illness have been found to have an increased risk of long-term mortality compared to patients not suffering from any severe mental illness. The causes identified were represented by the high burden of cardiovascular diseases, an unhealthy lifestyle and a poorer control of heart failure, and this has also been demonstrated in the case of a higher risk of mortality after advanced procedures for heart failure.