Trends in the development of suicide attempts and mood disorders following acute myocardial infarction: A decade-long analysis.

BACKGROUND

While survival rates following acute myocardial infarction (AMI) have improved, long-term psychiatric sequelae-particularly mood disorders and suicidality remain underexplored, especially across demographic subgroups and during periods of heightened societal stress, such as the COVID-19 pandemic.

OBJECTIVE

To assess decade-long trends (2013-2024) in the incidence of suicide attempts, depression, and bipolar disorder following AMI, and to examine demographic disparities and the influence of the COVID-19 pandemic on these outcomes.

METHODS

A retrospective cohort analysis was conducted using the TriNetX global research network, encompassing over 1.1 million AMI patients aged ≥18 without prior psychiatric diagnoses. Outcomes were measured using ICD-10 codes and stratified by sex, race/ethnicity, and pandemic period (pre-COVID: 2017-2020; COVID-era: 2020-2023). Trends were analyzed via compounded annual growth rates (CAGR) and regression models with interaction terms.

RESULTS

From 2013 to 2024, post-AMI suicide attempts increased significantly (CAGR: 20.10 %, p < 0.0001), with steeper growth in males and White patients. Depression and bipolar disorder also rose steadily (CAGR: 9.63 % and 7.91 %, respectively), with higher rates in females and minority groups. During the pandemic, suicide attempts increased notably among Black patients (p = 0.003), while depression rose significantly across all racial/ethnic groups, particularly among Hispanic individuals (CAGR: 11.71 %). Bipolar disorder incidence accelerated during the pandemic, especially in females and non-Hispanic cohorts. Across all outcomes, pandemic-related increases surpassed pre-pandemic trends.

CONCLUSION

Psychiatric morbidity following AMI has increased markedly over the past decade, with pandemic-related exacerbation and disproportionate impact on racial and ethnic minorities. These findings underscore the need for enhanced post-AMI mental health screening and culturally responsive interventions to address emerging disparities and optimize long-term outcomes.