Kate M Scott1, Sunny C D Collings. 1. Department of Psychological Medicine, University of Otago, Dunedin, New Zealand. kate.scott@otago.ac.nz
Abstract
BACKGROUND: Although it is widely believed that women with heart disease have poorer adjustment than men, the term 'adjustment' has typically been narrowly defined as depression. Gender differences in adjustment more broadly defined to encompass functional limitations in addition to depression have seldom been investigated, especially in general population samples with an adequate number of women. METHODS: A nationally representative general population survey of 7434 New Zealanders (618 with cardiovascular disease: CVD; 335 women, 283 men). DSM-IV mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). Health-related disability (functional limitations) was measured using the World Mental Health-World Health Organization Disability Adjustment Schedule (WHODAS-II). CVD was ascertained by self-report of a physician's diagnosis of heart disease, heart attack, or stroke. RESULTS: In age-adjusted analyses, cardiovascular disease was associated with significant functional limitations in a range of disability domains in both men and women, but there were no gender differences in the degree of disability. CONCLUSION: In this general population sample, men and women with CVD reported similar degrees of disability, despite women's higher prevalence of depression. This does not support earlier conclusions that women with heart disease cope less well than men.
BACKGROUND: Although it is widely believed that women with heart disease have poorer adjustment than men, the term 'adjustment' has typically been narrowly defined as depression. Gender differences in adjustment more broadly defined to encompass functional limitations in addition to depression have seldom been investigated, especially in general population samples with an adequate number of women. METHODS: A nationally representative general population survey of 7434 New Zealanders (618 with cardiovascular disease: CVD; 335 women, 283 men). DSM-IV mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). Health-related disability (functional limitations) was measured using the World Mental Health-World Health Organization Disability Adjustment Schedule (WHODAS-II). CVD was ascertained by self-report of a physician's diagnosis of heart disease, heart attack, or stroke. RESULTS: In age-adjusted analyses, cardiovascular disease was associated with significant functional limitations in a range of disability domains in both men and women, but there were no gender differences in the degree of disability. CONCLUSION: In this general population sample, men and women with CVD reported similar degrees of disability, despite women's higher prevalence of depression. This does not support earlier conclusions that women with heart disease cope less well than men.
Authors: Michael G Nanna; Alexandra M Hajduk; Harlan M Krumholz; Terrence E Murphy; Rachel P Dreyer; Karen P Alexander; Mary Geda; Sui Tsang; Francine K Welty; Basmah Safdar; Dharshan K Lakshminarayan; Sarwat I Chaudhry; John A Dodson Journal: Circ Cardiovasc Qual Outcomes Date: 2019-10-14