Depression and Anxiety in Women with Heart Disease

Depression and anxiety are extremely common conditions but are even more common in persons living with cardiovascular disease. Both conditions occur more frequently in women living with cardiovascular disease compared with men. Studies have demonstrated a link between coronary artery disease and depression, with an increased prevalence of depression in younger women living with CVD. Depression and anxiety are independent risk factors for cardiovascular disease and are associated with worse outcomes in those living with cardiovascular disease, particularly women. The purpose of this paper is to review the sex-based epidemiology of depression and anxiety in CVD and their possible mechanisms of impacting CVD risk factors and CVD outcomes in women with CVD.     

Perianal disease is associated with psychiatric co-morbidity in Crohn’s disease in remission

Background and aim

Crohn’s disease is a life-long inflammatory disease which can impair quality of life, in particular in patients with psychiatric co-morbidities such as depression and anxiety. The aim of this prospective cohort study was to assess the prevalence of depression and anxiety and related risk factors in patients with quiescent Crohn’s disease.

Methods

A consecutive series of adult patients with confirmed diagnosis of Crohn’s disease, in clinical remission, were included and investigated during ambulatory visits using a standard questionnaire assessing demographic and clinical features of the disease. Within 1 month after the ambulatory visit, all patients were interviewed by phone to assess the presence of psychiatric disorders using standardized questionnaires. The questionnaire assessed the development of psychiatric disorders after the diagnosis of Crohn’s disease, the use of antidepressant or antianxiety therapy and current anxiety or depression by means of the Hospital Anxiety and Depression Scale.

Results

One hundred and ninety-five patients were included. Seventy-two (36.9 %) patients showed anxiety and/or depression symptoms, 46 (23.6 %) patients showed anxiety symptoms, 6 (3.1 %) patients showed depression symptoms and 20 (10.3 %) patients showed both symptoms. Forty-eight of these patients (58 %) were without any antidepressive or antianxiety treatment. Anxiety with or without depression was significantly correlated with female sex (p?=?0.017), history of perianal disease (p?=?0.003) and perianal surgery (p?=?0.042).

Conclusion

Anxiety is a frequent, often untreated, condition in patient affected by Crohn’s disease in clinical remission. Female sex, history of perianal disease and perianal surgery are major risk factors for anxiety.     

Cardiovascular disease and psychological morbidity among rheumatoid arthritis patients

OBJECTIVES: To examine whether patients with rheumatoid arthritis (RA) with co-morbid cardiovascular disease (CVD) have different psychological morbidity (and psychosocial risk factors for it) compared with RA patients without co-morbid CVD. METHODS: Patients with RA and co-morbid CVD (n = 44; hypertension alone for n = 27) were compared with RA patients without CVD (n = 110). Differences in psychological morbidity (depression and anxiety) and psychosocial risk factors for this (arthritis self-efficacy, acceptance, social support and optimism) were examined while controlling statistically for medical and demographic covariates. RESULTS: Groups did not differ on RA duration, RA activity, marital status or socioeconomic status, but RA patients with co-morbid CVD were older, less likely to be female and less likely to be in employment than those without CVD. RA patients with co-morbid CVD had significantly higher depression and were more likely to score above cut-offs for depression than RA patients without CVD. No differences existed in anxiety, although anxiety appeared to be more common than depression. Low optimism was identified as a possible psychosocial risk factor for depression. CONCLUSIONS: RA patients with co-morbid CVD have higher depression than RA patients without CVD; low optimism is a potentially modifiable risk factor that may mediate this difference. RA patients with co-morbid CVD may benefit from systematic screening for depression and targeted intervention if necessary.     

Patient Anxiety and Depression Moderate the Effects of Increased Self-management Knowledge on Physical Activity: A Secondary Analysis of a Randomised Controlled Trial on Health-Mentoring in COPD

Objective. Anxiety and depression are common comorbidities in people with chronic obstructive pulmonary disease (COPD). While these comorbidities could potentially lead to a higher motivation to learn about self-management, they could also inhibit patients from translating this knowledge into appropriate self-management behaviours. This paper explores the moderating effects of anxiety and depression on a health-mentoring intervention, focusing on mechanisms of change (mediation). Methods. 182 COPD patients participated in an RCT, with anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS), self-management knowledge by the Partners in Health Scale, and spontaneous physical activity using accelerometers, all measured at baseline, 6 and 12 months. The moderated mediation model tested the intervention's effect on physical activity, mediated via changes in self-management knowledge, at different levels of anxiety and depression. Results. Knowledge mediated the effect of the intervention on changes in physical activity only for participants reporting low levels of anxiety or depression. Both acted as moderators: Increased knowledge led to more physical activity among participants reporting low anxiety or depression and to less activity among highly anxious or depressed participants. Conclusion. Although health-mentoring interventions can be an effective tool to increase knowledge and physical activity among COPD patients, it is essential to take anxiety and depression into account, as increased knowledge may have detrimental effects in highly anxious or depressed participants. This suggests that patients with elevated anxiety or depression may need to be treated appropriately before engaging in chronic disease self-management interventions.     

Anxiety of Alzheimer's disease: prevalence, and comorbidity.

BACKGROUND: Anxiety may be associated with psychiatric morbidity, disability, increased health care utilization, and mortality in Alzheimer's disease (AD) patients as it is in the general adult population. However, the phenomenology of anxiety symptoms in AD and its relationship to dementia progression, comorbid depression, and the presence of other problematic behaviors have not yet been examined. METHOD: Data on anxiety symptoms and their coexistence with other factors were obtained in 523 community-dwelling AD patients through interviews with their caregivers and direct physical examination. The prevalence of anxiety symptoms and their association to patient depression, other behavioral problems, gender, and age was investigated. RESULTS: Anxiety symptoms were common, occurring in 70% of subjects. Anxiety symptoms were significantly correlated with ADL impairment and other behavioral disturbances, including wandering, sexual misconduct, hallucinations, verbal threats, and physical abuse. Comorbidity of anxiety-depression was also prevalent: 54% of the sample had both anxiety and depression symptoms. ADL impairment and problem behaviors were significantly associated with comorbidity; however, the latter association was explained entirely by the presence of anxiety. CONCLUSION: Anxiety symptoms were common and significantly related to ADL and additional neuropsychiatric problems in this sample. These results indicate the need for additional research into the phenomenology of anxiety and comorbid anxiety-depression in AD and for the development and investigation of effective assessment and treatment of anxiety in AD clinical practice.     

Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease

Adherence to lifestyle recommendations for prevention of cardiovascular disease remains a critical issue. We examined the association of anxiety and depression with healthy behaviors in a large population of subjects at risk of cardiovascular disease. We studied 1612 consecutive subjects referred for evaluation of cardiovascular risk factors. Separated scores reflecting unhealthy behaviors (physical inactivity, smoking and poor diet) were combined to produce a global unhealthy lifestyle score. The Hospital Anxiety and Depression scale (HAD) was used to assess both anxiety and depression. Both anxiety and depression were significantly associated with physical inactivity in both sexes and with an unhealthy diet in men but not in women. Anxiety and depression were both significantly correlated to smoking habits in men whereas only depression was related to smoking in women. In both sexes, the global score reflecting unhealthy lifestyles was positively associated with the degree of anxiety and depression. In multivariate analysis, both anxiety and depression appeared as independent determinant of unhealthy lifestyle in both sexes, with a stronger influence for depression. Depression and to a lesser extent anxiety are associated with a cluster of unhealthy behaviors in subjects at risk of cardiovascular disease, suggesting the difficulty of modifying lifestyle in patients with anxious-depressive disorders.     

Anxiety associations with cardiac symptoms,angiographic disease severity,and healthcare utilization: The NHLBI-sponsored Women's Ischemia Syndrome Evaluation

Background

Anxiety is common among patients presenting with suspected coronary artery disease (CAD). In a sample of women with signs and symptoms of ischemia, we examined three anxiety markers as predictors of CAD endpoints including: 1) cardiac symptom indicators; 2) angiographic CAD severity; and 3) healthcare utilization (cardiac hospitalizations and 5-year cardiovascular [CVD] healthcare costs).

Methods

Participants completed a baseline protocol including coronary angiogram, cardiac symptoms, psychosocial measures and a median 5.9-year follow-up to track hospitalizations. We calculated CVD costs based on cardiac hospitalizations, treatment visits, and CVD medications. Anxiety measures included anxiolytic medication use, Spielberger Trait Anxiety Inventory (STAI) scores, and anxiety disorder treatment history.

Results

The sample numbered 514 women with anxiety measure data and covariates (mean age = 57.5 [11.1]). One in five (20.4%) women reported using anxiolytic agents. Anxiety correlated with cardiac symptom indicators (anxiolytic use with nighttime angina and nitroglycerine use; STAI scores and anxiety disorder treatment history with nighttime angina, shortness of breath, and angina frequency). Anxiety disorder treatment history (but not STAI scores or anxiolytics) predicted less severe CAD. Anxiolytic use (but not STAI scores or anxiety disorder treatment history) predicted hospitalizations for chest pain and coronary catheterization (HRs = 2.0, 95% CIs = 1.1–4.7). Anxiety measures predicted higher 5-year CVD costs (+ 9.0–42.7%) irrespective of CAD severity.

Conclusions

Among women with signs and symptoms of myocardial ischemia, anxiety measures predict cardiac endpoints ranging from cardiac symptom severity to healthcare utilization. Based on these findings, anxiety may warrant greater consideration among women with suspected CAD.     

心血管疾病患者焦虑抑郁症状调查研究

目的了解心血管疾病患者焦虑抑郁症状发病情况和临床特征并分析其影响因素,为临床治疗提供依据。方法纳入2012年1月～2012年3月1105例心血管疾病患者,所有患者均接受综合医院焦虑抑郁量表、汉密尔顿抑郁量表和汉密尔顿焦虑量表进行心理状况检测,评估焦虑、抑郁的发生率,采用Logistic回归分析对相关危险因素进行评价,观察在使用心血管药物治疗联合心理干预的治疗效果。结果所纳入心血管疾病患者中焦虑和抑郁患者占22.81%（252/1105）,其中53.97%（136/252）为焦虑,31.35%（79/252）为抑郁,14.68%（37/252）同时合并焦虑和抑郁。多因素非条件Logistic回归分析显示：健康状况、工作状态和工作劳累程度是焦虑抑郁的主要危险因素（P＜0.05）。在使用心血管药物治疗的基础上合并使用抗焦虑抑郁药物同时配合心理干预治疗后总有效率达95.63%。结论心血管疾病住院患者中焦虑抑郁症状发病率较高,焦虑抑郁症状受到多种因素影响,在治疗心血管疾病的基础上进行抗焦虑抑郁治疗有助于改善患者整体状况。     

Anxiety in rheumatoid arthritis

OBJECTIVE: To examine the level of anxiety experienced by individuals with rheumatoid arthritis (RA). METHODS: Data from 2 previous studies were used to compare the level of anxiety (measured by the State-Trait Anxiety Inventory) in the following 4 subgroups: a general RA sample, a general osteoarthritis sample, a sample with both RA and major depression, and a normative sample of age-equivalent, working adults. Canonical correlations were used to examine associations between measures of anxiety and measures of both stress and depression. The relationship between anxiety and duration of RA was also explored. RESULTS: The general RA sample had state anxiety levels that were comparable to the normative sample, although trait anxiety levels were significantly higher (P < 0.001). In addition, individuals with RA who also met criteria for depression exhibited significantly higher levels of both state anxiety (P < 0.0001) and trait anxiety (P < 0.0001) than was observed in the normative sample. Canonical correlations revealed that measures of anxiety were correlated with both measures of depression (r = 0.83) and measures of stress (r = 0.50). Anxiety was not found to be significantly related to RA disease duration. CONCLUSION: These findings demonstrated that individuals with RA, especially if concomitantly depressed, tend to exhibit levels of anxiety that are generally higher than a normative group of age-equivalent, working adults. The substantial canonical correlations between anxiety and both depression and stress revealed that anxiety shares variance with these more frequently studied variables in RA. However, anxiety was not found to be related to RA disease duration.     

以胸闷为表现的抑郁／焦虑症误诊为冠心病456例临床分析

目的探讨抑郁／焦虑症在心血管系统的临床表现,提高医生的识别能力。方法总结和分析456例误诊为冠心病的以胸闷为表现的抑郁／焦虑症患者的症状、体征等』临床特点。结果456例患者均表现为典型或类似的心绞痛症状,并都接受冠心病治疗,但是客观检查未见明显异常。进行汉密尔顿抑郁量表（HAMD）和焦虑量表（HAMA）评分,患者均不同程度地存在抑郁或焦虑症状,经过抗抑郁／焦虑治疗症状均得到缓解。结论对于以胸闷为l临床表现的患者,在进行心血管系统检查治疗的同时,不能忽视是抑郁或焦虑所致。提高医生识别意识是诊断抑郁或焦虑症的关键。     

Anxiety and depression after coronary artery bypass graft surgery: most get better, some get worse

BACKGROUND: To target interventions, patients at risk for poor outcomes after a cardiac event need to be identified. We investigated trajectories of anxiety and depression after coronary artery bypass graft surgery (CABGS) and identified patients at risk of persistent or worsening anxiety and depression. METHODS: A consecutive sample of 184 patients on the waiting list for CABGS at The Royal Melbourne Hospital completed self-report questionnaires before surgery, and at 2 and 6 months postsurgery. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Growth mixture modelling identified trajectories of anxiety and depression. RESULTS: Two possible trajectories emerged for anxiety, whereas three trajectories emerged for depression. Most patients (92%) followed a trajectory of minor presurgical anxiety that remitted in 6 months after CABGS, with the remainder (8%) following a trajectory of major anxiety that remitted in the same period. Minor remitted depression was also common (72% patients). Two less common depression trajectories indicated worsening or unresolved depression. One trajectory began with major presurgical depression that partially remitted by 6 months (14% patients) and the other began with minor presurgical depression that worsened by 6 months (14% patients). Unpartnered patients, smokers, those with presurgical anxiety, high cholesterol, angina, more severe disease or having repeat CABGS were at increased risk for a poor depression trajectory. CONCLUSION: Although initial anxiety and depression resolved or lessened for most patients, some patients experienced persistent or worsening depression after CABGS. Interventions can be targeted toward 'at risk' patients.     

Are anxiety and depression related to gastrointestinal symptoms in the general population?

BACKGROUND: In clinical studies there is a strong relationship between gastrointestinal symptoms, anxiety and depression. The results may be biased, however, since anxiety and depression will influence the decision to consult a doctor. The aim of this study was to investigate the relationship between these symptoms in the population. METHODS: In the Health Study of Nord-Tr?ndelag County of Norway (HUNT) a questionnaire concerning physical and mental health, demographic and life-style factors was sent to all inhabitants aged 20 years and above (a total of 94,197 persons). Valid questionnaires were returned by 62,651 persons (66.5%). Presence of nausea, heartburn, diarrhoea and constipation during the last year was self-reported. Anxiety disorders and depression were based on self-ratings of the Hospital Anxiety and Depression Scale (HADS). RESULTS: 48% of the population reported one or more of the four gastrointestinal symptoms. Based on the HADS ratings, 15.3% of the population had an anxiety disorder and 10.4% a depression. Anxiety disorder was most strongly associated with nausea (OR 3.42). Anxiety was also associated with heartburn, diarrhoea and constipation, but weaker than with nausea. Depression was less strongly associated with the four gastrointestinal symptoms. Demographic factors, life-style factors and extra-gastrointestinal complaints could not explain the effect of anxiety disorders and depression on these gastrointestinal symptoms. CONCLUSIONS: In this population study there was a strong relationship between gastrointestinal symptoms, anxiety disorders and depression. These findings suggest that mental disorders in patients with gastrointestinal symptoms are not merely a consequence of selection bias in patient materials but connected to the symptoms themselves.     

焦虑抑郁情绪对冠心病患者血清炎症因子及血管内皮功能的影响

目的:探讨焦虑抑郁情绪对冠心病患者血清炎症因子水平及血管内皮功能的影响.方法:选择60例冠心病患者,使用焦虑抑郁量表评价其心理状态,根据评分将冠心病患者分为焦虑抑郁组(30例)和非焦虑抑郁组(30例),测定受试者的血清高敏C反应蛋白、细胞间黏附分子-1和肿瘤坏死因子-α水平,并采用高分辨率超声法测定肱动脉血流介导的舒张反应(FMD).结果:焦虑抑郁组血清细胞间黏附分子-1和肿瘤坏死因子-α水平较非焦虑抑郁组显著升高(P均<0.05),焦虑抑郁组的肱动脉血流介导的舒张反应较非焦虑抑郁组降低(P<0.05),差异均有统计学意义.采用多元线性回归分析发现,在调整了体重指数、收缩压、年龄、性别、吸烟史、糖尿病史、心率、低密度脂蛋白胆固醇等混杂因素的影响之后,细胞间黏附分子-1和肱动脉血流介导的舒张反应与四种不同量表得分均呈独立正相关(P<0.05),肿瘤坏死因子-α与汉密尔顿焦虑量表、汉密尔顿抑郁量表、焦虑自评量表得分呈独立正相关(P均<0.05),但肿瘤坏死因子-α与抑郁自评量表得分、高敏C反应蛋白与四种不同量表得分无明显相关性(P>0.05).结论:焦虑抑郁情绪可能加重冠心病患者体内的炎症反应及内皮功能损害.     

Validity of Self-rating Screening Scales for the Diagnosis of Depression and Anxiety in Adult Patients With Bronchiectasis

BackgroundThere are no previous studies aimed at assessing the validity of the screening scales for depression and anxiety in adult patients with bronchiectasis.AimsTo analyze the psychometric properties of Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and Hamilton Anxiety Scale and to evaluate the concordance for the diagnosis of depression and anxiety between these screening scales and the structured clinical interview in adult patients with bronchiectasis.MethodCross sectional study. 52 patients with bronchiectasis completed HADS, BDI and Hamilton Anxiety Scale; afterwards, were individually interviewed by a mental health care professional using the structured Mini International Neuropsychiatric Interview (MINI), which evaluates for depression and anxiety according to DSM-IV criteria.ResultsBased on MINI, 18 subjects (34.6%) had a diagnosis of depression and 25 (48.1%) had anxiety. Optimal cut-off values to detect depression were ≥9 for the HADS-D (sensitivity 0.833, specificity 0.971, AUC 0.962 [95% CI 0.918–1]), and 17 for BDI (sensitivity 0.889, specificity 0.912, AUC 0.978 [95% CI 0.945–1]). Optimal cut-off values to detect anxiety were ≥4 for the HADS-A (sensitivity 0.960, specificity 0.593, AUC 0.833 [95% CI 0.723–0.943]), and 17 for Hamilton Anxiety Scale (sensitivity 0.800, specificity 0.852, AUC 0.876 [95% CI 0.781–0.970]).ConclusionThe self-rating screening scales HADS, BDI and Hamilton Anxiety Scale are reliable tools to screen for depression and anxiety in adult patients with bronchiectasis. However, the use of specific cut-off values may improve the diagnostic accuracy of the previous scales in this specific group of patients.     

Effekte einer multimodalen Intervention zur Prim?rpr?vention kardiovaskul?rer Krankheiten auf Depressivit?t, Angst und Typ-D-Muster

Depression, anxiety, and Type-D pattern are associated with the earlier development and faster progression of cardiovascular disease (CVD). The aim of the randomized controlled PreFord trial was to improve multiple biological and psychosocial risk factors in the primary prevention of CVD. A total of 447 women and men with an ESC risk score >5% were randomly assigned to either multimodal or routine care groups. Somatic and psychosocial variables (HADS, DS-14) were assessed before and after the intervention, and annually for 2 years thereafter. The intervention showed no significant effects on the symptoms of depression, anxiety, and type D personality, either in the whole sample or in those with elevated scores at baseline. Thus, our study did not provide evidence that symptoms of depression, anxiety, or Type D personality can be effectively treated by multimodal behavioral interventions for the primary prevention of CVD.     

Controversies surrounding the comorbidity of depression and anxiety in inflammatory bowel disease patients: a literature review

Psychological disorders are highly prevalent in patients with inflammatory bowel disease (IBD). Anxiety and depression are known to independently affect quality of life and may additionally impair quality of life in IBD over and above the IBD itself. Some researchers have further proposed that anxiety and depression may influence the clinical course of IBD. However, despite the potential for anxiety and depression to play an important role in the clinical picture of IBD, there is little prospective well-controlled research in this area. Probably because of this lack of clear data, researchers dispute the actual role of these psychological disorders in IBD, with a number of conflicting opinions expressed. This article reports on a review of the literature in this field. Herein we discuss the five main areas of controversy regarding IBD and the specific psychological comorbidities of depression and anxiety: 1) the relative rate of cooccurrence of these psychological disorders with IBD; 2) the cooccurrence of these psychological disorders with particular phase of IBD; 3) the cooccurrence of these psychological disorders with the specific type of IBD; 4) the rate of these psychological comorbidities compared both to healthy subjects and to other disease states; and 5) the timing of onset of psychological comorbidity with respect to onset of IBD. Methodological weaknesses of the reviewed studies make it impossible to resolve these controversies. However, the results clearly show that anxiety/depression and IBD frequently interact. Given the long-term illness burden patients with IBD face, further prospective, appropriately controlled studies are needed to adequately answer the question of the precise interplay between anxiety/depression and IBD.     

Original research: Important relation between self-efficacy,sense of coherence,illness perceptions,depression and anxiety in patients with inflammatory bowel disease

IntroductionAnxiety and depression are common disturbances in patients with inflammatory bowel diseases (IBD), and were found to impact the disease course. Illness perceptions (IPs), self-efficacy (SE) and sense of coherence (SOC) are important psychological functions, used by the individual to cope with his chronic disease.Aimsto investigate the association of IP, SE and SOC on anxiety and depression among patients with IBD.Patients and methodsPatients filled questionnaires including: demographic, socioeconomic and clinical features. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. IP, SE and SOC were assessed using the Brief Illness perception Questionnaire, IBD-SE and SOC scales.ResultsThe study sample consisted of 299 patients with IBD, median age 34.15, 63% females, 70.9% had Crohn’s disease, filled the questionnaires. In the multivariate analysis, lower results in IP, SE and SOC were found to be associated with significantly increase anxiety (OR 8.35, p<0.001; OR 4.18, p=0.001; OR 4.67, p<0.001, respectively) and depression (OR 15.8, p=0.001; OR 10.99, p=0.029; OR 6.12, p=0.014ConclusionsAnxiety and depression are associated with IP, SE and SOC in patients with IBD. Clinicians should be aware of this impact, recognise their patients’ psychological abilities to cope with the disease and improve those abilities, when needed, in order to achieve a better coping with the disease and to prevent the development of anxiety and depression.     

Anxiety and depression in adult patients with celiac disease on a gluten-free diet

AIM: To compare anxiety and depression levels in adult patients with celiac disease (CD) on a gluten-free diet (GFD) with controls.METHODS: The levels of anxiety, depression and of a probable anxiety or depressive disorder were assessed by the Hospital Anxiety and Depression Scale in 441 adult patients with CD recruited by the German Celiac Society, in 235 age-and sex-matched patients with inflammatory bowel disease (IBD) in remission or with slight disease activity, and in 441 adult persons of a representa...     

Baduanjin exercise can alleviate anxiety and depression of patients with COVID-19 in Square cabin hospital: A cross-sectional survey

To investigate the anxiety and depression of patients with the coronavirus disease 2019 (COVID-19) who participated in Baduanjin exercise.From February 20, 2020 to March 7, 2020, the Hospital Anxiety and Depression scale (HAD) were used to investigate the anxiety and depression levels of patients with COVID-19 who participated in Baduanjin exercise. Ninety one questionnaires were received, including 40 males and 51 females. Stepwise regression analysis was used to analyze the effects of related factors on anxiety and depression levels.In Square cabin hospital, 91% of patients participated in Baduanjin exercise had no obvious anxiety and 82% had no obvious depression. The scores of anxiety and depression of female patients were significantly higher than that of male patients. Bachelor degree or above with low scores for anxiety and depression. The frequency of Baduanjin exercise was negatively correlated with anxiety and depression score.The development of Baduanjin exercise has a certain positive influence on the COVID-19 patients in the Square cabin hospital, which is conducive to alleviate anxiety and depression symptoms of the patients.     

Depression and cardiovascular disease: The deep blue sea of women's heart

Cardiovascular disease (CVD) constitutes a leading worldwide health problem, with increasing evidence of differences between women and men both in epidemiology, pathophysiology, clinical management, and outcomes. Data from the literature suggest that women experience a doubled incidence of CVD related deaths, while angina, heart failure and stroke are increasingly prevalent in females. About 20–25% of women go through depression during their life, and depressive symptoms have been considered a relevant emergent, non-traditional risk factor for CVD in this part of the general population. Underlying mechanisms explaining the link between depression and CVD may range from behavioral to biological risk factors, including sympathetic nervous system hyperactivity and impairment in hypothalamic-pituitary-adrenal function. However, the neuroendocrine-driven background could only partially explain the differences mentioned above for chronic systemic inflammation, altered hemostasis and modulation of cardiac autonomic control. In addition, some evidence also suggests the existence of gender-specific differences in biological responses to mental stress. Given these premises, we here summarize the current knowledge about depression and CVD relationship in women, highlighting the sex differences in physiopathology, clinical presentation and treatments.