Depression and mortality have been studied separately in patients with coronary heart disease (CHD) and in populations healthy at study inception. This does not allow comparisons across risk-factor groups based on the cross-classification of depression and CHD status. We prospectively examined the effects of depressive symptoms, assessed in 2002-2004, on all-cause and cardiovascular -mortality in a large sample of 5936 middle-aged participants, with and without established CHD, followed over 5.6 years

We created 4-risk-factor groups based on the cross classification of depressive symptoms and CHD status. The age-and-sex-adjusted hazard ratios for all causes death were 1.67-fold (p< 0.05) higher for participants with only CHD, 2.10-fold (p< 0.001) higher for those with only depressive symptoms and 4.99-fold (p< 0.001) higher for those with both CHD and depressive symptoms when compared to participants without either condition. The two latter risk-factor groups remained at increased risk after adjustments for relevant confounders. Further comparisons indicated that the risks of all-cause death were also higher, but to a lesser extent, for participants with both depressive-symptoms and CHD when compared to those with only one of these conditions. These associations were also observed for cardiovascular mortality

This study provides evidence that depressive symptoms are associated with an increased risk of all-cause and CVD death and that this risk is particularly marked in depressive participants with co-morbid CHD. Several clinical guidelines have recommended screening, referral, and treatment of depression in primary and cardiovascular care units. These findings suggest that these recommendations need further consideration.

Prospective data on depressive symptoms and blood pressure (BP) are scarce, and the impact of age on this association is poorly understood.

The present study examines longitudinal trajectories of depressive episodes and the probability of hypertension associated with these trajectories over time.

Participants were 6,889 men and 3,413 women London based civil servants followed for 24 years between 1985 and 2009. The age of participants over the follow-up ranged from 35 to 80 years. Depressive episode (defined as scoring 4 or more on the General Health Questionnaire-Depression subscale or using prescribed antidepressant medication) and hypertension (systolic/diastolic blood pressure ≥ 140/90 mm Hg or use of antihypertensive medication) were assessed concurrently at five medical examinations.

In longitudinal logistic regression analyses based on Generalized-Estimating-Equation using age as the time scale, participants with depression trajectory characterised by increasing depressive episodes overtime had a greater increase in the likelihood for hypertension with advancing age; an adjusted-excess increase of 7% (95% CI 3-12, p < 0.001) for each five-year increase in age compared to those with a low/stable depression trajectory. In a model adjusted for relevant confounders, a higher risk of hypertension in the first group of participants did not become evident before age 55. A similar pattern of association was observed in men and women although the association was stronger in men.

This study suggests that the risk of hypertension increases with repeated experience of depressive episodes over time and materializes in later adulthood.

Risk of retirement from work before statutory retirement age among employees with personality disorders is unknown.

We used diagnoses of awarded medical rehabilitations and hospitalisations to select two clinical cohorts from a population of 151,618 employees: participants in rehabilitation (total N = 1942, 233 personality disorder, 419 anxiety disorder and 1290 depression cases) and hospitalised patients (N = 1333, 354, 126 and 853, respectively). Early retirement from work was tracked through national registers during a period of 5 years. Cox proportional hazard models were used to examine the association of diagnostic groups with risk of early retirement.

In models adjusted for age, sex and socioeconomic position, the relative risk of early retirement for patients with personality disorders was 3.5-fold (95% CI 2.1 to 5.8) in the rehabilitation cohort and 2.3-fold (95% CI 1.6 to 3.5) in the hospital cohort compared with anxiety disorders. The corresponding hazard ratios of early retirement for personality disorders compared with depressive disorders were 1.1 (95% CI 0.8–1.5) and 1.7 (95% CI 1.4–2.1), respectively.

Personality disorders increase the risk of early retirement at least to an equal extent as depression and more than twice that of anxiety disorders.

Although accumulating evidence suggests that individuals with mental disorders have an increased risk of mortality from physical illnesses, the underlying mechanisms remain to be fully understood.

To examine the association between mental disorder status and self-reported treatment for major somatic diseases, including respiratory, cardiovascular (CVD), metabolic diseases, and cancer over a 12-year follow-up period.

To test whether people with mental disorders are less likely to be treated for somatic diseases.

In the large prospective French GAZEL cohort of 15 798 employees, mental disorder was defined as at least one sickness absence exceeding 7 days from 1989 – 2000 and self-reported treatment of somatic diseases was assessed from 2001 – 2011. Longitudinal logistic regression models based on generalized estimating equations were used to study the association.

In fully adjusted-models, a diagnosis of severe mental disorder was associated with an 18% and a 6% greater annual increase in the likelihood of receiving treatment for respiratory disease and CVD over time, respectively. Any mental disorder was associated with a 2% greater annual decrease in the likelihood of receiving treatment for CVD over time. Depressive disorder (3%), mental disorders due to substance abuse, and mixed mental disorders (2%) had similar patterns of decrease.

This longitudinal study suggests that the impact of mental disorders on treatment receipt for somatic disorders depends on the diagnostic categories. People with depressive disorder, mental disorders due to substance use, and mixed mental disorders may be at risk of not receiving treatment for CVD.

The psychosocial vulnerability model of hostility posits that hostile individuals, given their oppositional attitudes and behaviours, are more likely to have increased interpersonal conflicts, lower social support, more stressful life events (SL-E) and higher likelihood of depression. However, little research has tested this hypothesis using large-scale prospective samples. The present study aims to assess the predictive value of hostility for depressive mood.

Data are from 3399 participants in the Whitehall II cohort study, aged 35–55 years at baseline (phase 1 1985–1988). Cynical hostility was measured at phase 1. Depressive mood was assessed at phase 7 (2002–2004). Sociodemographic characteristics, health-related behaviours, common mental disorders and antidepressant medication intake were assessed at phase 1. SL-E and confiding/emotional support were measured at phases 1, 2 (1989–1990) and 5 (1997–1999).

Compared with participants in the lowest quartile of cynical hostility, those in the highest quartiles were more likely to have depressive mood [second quartile: odds ratio (OR) 1.58, 95% confidence interval (CI) 1.14–2.20; third quartile: OR 2.78, 95% CI 2.03–3.77; fourth quartile: OR 4.66, 95% CI 3.41–6.36] in analysis adjusted for sociodemographic characteristics. This graded association was somewhat attenuated (⩽18%) but remained robust to adjustments for the covariates measured at baseline and follow-up. The association was also evident in participants free of mental health difficulties at baseline.

Cynical hostility is a strong and robust predictor of depressive mood. Consideration of personality characteristics may be crucial to the understanding and management of depression.