Mental disorders and the emergence of physical disorders
Mental disorders and the emergence of physical disorders
A substantial body of evidence now demonstrates a consistent association between emotion, emotion-related disorders, health, and scholarly attention is increasingly focused on the potential importance of mental health in determining physical health. Scepticism that psychological disorders do indeed lead to poor physical health stems from several sources. Primary concerns revolve around potential reverse causality, the third variable problem, and determining whether physical symptoms that accompany affective experience are truly indicative of organic underlying illness. A more comprehensive understanding of the interrelationship between mental and physical health would substantially improve our ability to devise targeted prevention and intervention strategies to improve population health. This chapter considers whether mental disorders contribute to the development of physical diseases, specifically in relation to cardiovascular disease (CVD). The chapter begins with an overview of the adult literature, prioritizing prospective epidemiological studies that use the most rigorous methods available for assessing the associations. The emerging literature investigating the impact of psychological functioning earlier in life on cardiovascular risk markers and pre-disease conditions across the life course is then considered. The combined evidence suggests that early psychological functioning is important for cardiovascular health throughout adulthood, but a number of important questions remain. Key issues are unresolved, including the degree to which timing of onset and chronicity of psychological distress across the life course influence CVD risk, and how physiological dysregulation early in life due to psychological dysfunction becomes evident.
Keywords: anxiety, depression, cardiovascular disease, biomarkers, childhood psychological functioning
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