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IJE Advance Access originally published online on May 6, 2004
International Journal of Epidemiology 2004 33(4):779-786; doi:10.1093/ije/dyh077
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IJE vol.33 no.4 © International Epidemiological Association 2004; all rights reserved.

Article

Anxiety or depressive disorders and risk of ischaemic heart disease among French power company employees

C Allonier1, A Chevalier1, M Zins2, O Catelinois1, SM Consoli3, M Goldberg2 and G Lahon1

1 Service General de Medecine de Contrôle (SGMC), Electricité de France-Gaz de France
2 INSERM U88
3 Department of Psychological Medicine and C-L Psychiatry, Georges Pompidou European Hospital

Correspondence: Anne Chevalier, Service General de Medecine de Contrôle, EDF et Gaz de France, 22/28 Rue Joubert—75009 Paris, France. E-mail: anne.chevalier{at}edfgdf.fr

Background The aim of this study was to determine whether depression and anxiety are predictive factors for ischaemic heart disease among adults <60 years.

Method A case-control study among active employees of the French nationwide power company (Electricité de France—Gaz de France) analysed men aged 31–55 years who presented an initial clinical form of ischaemic heart disease from 1993 through 1997, collected from the company registry. These 660 men were each matched by age to 10 controls per case. Adjusted odds ratios (OR) were calculated by logistic regression.

Results There was a significant association between ischaemic heart disease and sick-leave for any medical reason in the 3 years before its onset (OR = 1.79; 95% CI: 1.50, 2.14). This association was strengthened when only absences for depression and anxiety were considered (OR = 3.10; 95% CI: 2.29, 4.19) and remained important and significant when adjusted for socioeconomic status: OR = 2.66 (95% CI: 1.95, 3.63). A previous sick-leave for depression or anxiety in the 10 years before the heart disease strengthened the association (OR = 3.61; 95% CI: 2.39, 4.45), which was further reinforced by an elevated number (≥4) of such sick-leaves (OR = 5.11; 95 % CI: 3.11, 8.40).

Conclusion Depressive and anxiety disorders that lead to absenteeism seem to be associated with an increased risk of ischaemic heart disease in the 3 years thereafter, especially when depression and anxiety were severe and chronic; this association is independent of socioeconomic status.

Keywords Myocardial infarction, angina pectoris, epidemiology, depressive disorders, socioeconomic status

Accepted 19 November 2003


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