The Relationship Between Mental Disorders and Heart Diseases Among General Workers: A Systematic Review and Meta-Analysis.
Mingxing Wang, Yun Wu, Xiaoyu Zhu
Depression, anxiety, and PTSD were each linked to a higher risk of heart disease among workers.
The 34 studies varied widely, and the anxiety range includes no effect, so the strength of each link is uncertain.
Key findings
130 of the 34 included studies reported a significant association between mental disorders (depression, anxiety, or PTSD) and heart disease.
2Pooled odds ratios for heart disease were 1.53 for depression (95% CI: 1.26 to 1.80), 1.87 for anxiety (95% CI: 0.13 to 3.61), 1.70 for PTSD (95% CI: 1.34 to 2.05), and 1.52 for mental disorders overall (95% CI: 1.33 to 1.71).
3Heterogeneity across the pooled studies was high (I² from 75.2% to 95.2%), and publication bias was detected by Egger's test.
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What it does not show
The included studies varied enormously in design, population, and measurement, producing very high heterogeneity (I² up to 95.2%), which makes the pooled estimate uncertain. Only two studies examined anxiety and two to three examined PTSD, so the pooled estimates for these disorders rest on very few data points. Publication bias was detected, meaning unpublished studies with null results may be missing from the pool. Several studies relied on self-reported mental health rather than clinical diagnosis. The analysis was restricted to English-language publications. Non-occupational confounders such as smoking, medication use, and comorbidities were not consistently controlled across the included studies. The anxiety pooled odds ratio of 1.87 has a confidence interval of 0.13 to 3.61, which includes 1.0 (no effect), yet the paper reports p < .001. This internal inconsistency makes the anxiety finding unreliable as stated.
Declared interests
The authors received no funding and declared no conflicts of interest.
The easy way to misread this
The pooled odds ratio for anxiety is 1.87 with a confidence interval of 0.13 to 3.61, which includes 1.0 (no effect), yet the paper reports p < .001. Do not treat the anxiety finding as firmly established. The overall heterogeneity is also very high, so the pooled estimates should be read as approximate rather than precise.
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