Depression and anxiety in patients with heart disease and/or cancer based on the National Health Interview Survey

Abstract

Depression and anxiety in patients with heart disease and/or cancer have been shown to affect quality of life, adherence with medical management, and prognosis. We investigated the association of the diagnoses of cancer, heart disease, or both with self-reported symptoms consistent with serious mental illness (SMI). We used the K6 score to identify self-reported symptoms consistent with SMI from patients’ responses to the 2017 National Health Interview Survey. Our final cohort included 24,777 individual surveys. Of those respondents, 1509 reported cancer, 2639 reported heart disease, and 534 reported both. About 96% of patients reported a K6 score <13, and 4% reported a K6 score ≥13, which is suggestive of SMI. Logistic regression identified significant associations between SMI and an inability to afford mental care/counseling, an inability to afford prescribed medications, and unemployed status, with odds ratios of 6.97, 2.94, and 3.49, respectively. Having both heart disease and cancer was independently associated with SMI (odds ratio = 2.57; 95% confidence interval, 1.53–4.31; P < 0.001). In conclusion, in a nationally representative self-reported questionnaire, patients with a combined diagnosis of cancer and heart disease were significantly more likely to report SMI than those with either diagnosis alone.

Keywords:

• Anxiety
• cardio-oncology
• depression
• epidemiology
• National Health Interview Survey