Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-05T04:33:29.741Z Has data issue: false hasContentIssue false

Symptoms of psychological distress predict 7-year mortality

Published online by Cambridge University Press:  09 July 2009

Felicia A. Huppert*
Affiliation:
Department of Psychiatry, University of Cambridge
Joyce E. Whittington
Affiliation:
Department of Psychiatry, University of Cambridge
*
1Address for correspondence: Dr Felicia A. Huppert, University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ.

Synopsis

As part of the Health and Lifestyle Survey (HALS), 6096 adults from a representative sample of community residents completed a standardized questionnaire which elicited psychiatric symptoms – the General Health Questionnaire (GHQ-30) of Goldberg (1972). Their survival status at 7 years was determined, and 474 had died. Respondents whose GHQ score was above the conventional threshold (4/5), used when screening for psychiatric disorder, were 60% more likely to die over the 7-year interval than respondents whose GHQ score was below threshold (risk ratio 1·64 for men and 1·58 for women). The differences were statistically significant for both sexes when the effects of age, physical disorder, social class and smoking behaviour were taken into account. Personality traits (neuroticism, extraversion) were not related to mortality, neither was self-reported difficulty in sleeping. However, a low subjective rating of one's general health was associated with increased mortality. We explored a range of cut-points and found reliable effects for both sexes at all cut-points from 3/4 to 6/7. Possible differences related to natural versus unnatural causes of death were explored and found not to explain the results. The findings from this general population study confirm that it is not only psychiatric disorders, but also psychiatric symptoms, which are associated with subsequent mortality, and thereby reinforce the importance of appropriate intervention to alleviate these symptoms.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almada, S. J., Zonderman, A. B., Shekelle, R. B., Dyer, A. R., Daviglus, M. L., Costa, P. T. & Stamler, J. (1991). Neuroticism and cynicism and risk of death in middle-aged men: the Western Electric Study. Psychosomatic Medicine 53, 165175.CrossRefGoogle ScholarPubMed
Anda, R., Williamson, D., Jones, D., Macera, C., Eaker, E., Glassman, A. & Marks, J. (1993). Depressed affect, hopelessness, and the risk of ischemic heart disease in a cohort of U.S. adults. Epidemiology 4, 285294.CrossRefGoogle Scholar
Baker, R. J. & Nelder, J. A. (1985). The GLIM System: Release 3.77 GLIM Manual. Numerical Algorithms Group: Oxford.Google Scholar
Berkman, L. F. & Syme, S. L. (1979). Social networks, host resistance and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology 109, 186204.CrossRefGoogle ScholarPubMed
Black, D. W., Winokur, G., Mohandoss, E., Woolson, R. F. & Nasrallah, A. (1989). Does treatment influence mortality in depressives? A follow-up of 1076 patients with major affective disorders. Annals of Clinical Psychiatry 1, 165173.CrossRefGoogle Scholar
Blaxter, M. (1987). Sample and data collection. In The Health and Lifestyle Survey (ed. Cox, B. D., Blaxter, M., Buckle, A. L. J., Fenner, N. P., Golding, J. F., Gore, M., Huppert, F. A., Nickson, J., Roth, M., Stark, J., Wadsworth, M. E. J. and Whichelow, M. J.), pp. 13. The Health Promotion Research Trust: London.Google Scholar
Blaxter, M. & Prevost, A. T. (1993). Patterns of Mortality. In The Health and Lifestyle Survey: Seven Years On (ed. Cox, B. D., Huppert, F. A. and Whichelow, M. J.), pp. 3346. Dartmouth Press: Aldershot.Google Scholar
Bliwise, D. L., Friedman, L. & Yesavage, J. A. (1993). Depression as a confounding variable in the estimation of habitual sleep time. Journal of Clinical Psychology 49, 471477.3.0.CO;2-7>CrossRefGoogle ScholarPubMed
Casadebaig, F. & Quemada, N. (1989). Mortality in psychiatric inpatients. Acta Psychiatrica Scandinavica 79, 257264.CrossRefGoogle ScholarPubMed
Chipperfield, J. G. (1993). Incongruence between health perceptions and health problems. Journal of Aging and Health 5, 475496.CrossRefGoogle Scholar
Cox, B. D., Huppert, F. A. & Whichelow, M. J. (1993). The Health & Lifestyle Survey: Seven Years On. Dartmouth: Aldershot.Google Scholar
Enzell, K. (1984). Mortality among persons with depressive symptoms and among responders and non-responders in a health check-up. Acta Psychiatrica Scandinavica 69, 89102.CrossRefGoogle Scholar
Eysenck, H. J. & Eysenck, B. G. (1964). Manual of the Eysenck Personality Inventory. Hodder and Stoughton: London.Google Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Goldberg, D. P. & Williams, P. (1988). A User's Guide to the General Health Questionnaire. NFER-Nelson: Windsor.Google Scholar
Goldberg, E. L., Comstock, G. W. & Hornstra, R. K. (1979). Depressed mood and subsequent physical illness. American Journal of Psychiatry 136, 530534.CrossRefGoogle ScholarPubMed
Haynes, S. G., Levine, S., Scotch, N., Feinleib, M. & Kannel, W. B. (1978). The relationship of psychosocial factors to coronary heart disease in the Framingham study. American Journal of Epidemiology 107, 362383; and 384–402.CrossRefGoogle ScholarPubMed
House, J. S., Landis, K. R. & Umberson, D. (1988). Social relationships and health. Science 241, 540545.CrossRefGoogle ScholarPubMed
Jagger, C. & Sutton, C. J. (1991). Death after marital bereavement – Is the risk increased? Statistics in Medicine 10, 395404.CrossRefGoogle ScholarPubMed
Kaprio, J., Koskenvuo, M. & Rita, H. (1987). Mortality after bereavement: a prospective study of 95647 widowed persons. American Journal of Public Health 77, 283287.CrossRefGoogle Scholar
Kerr, T. A., Schapira, K., Roth, M. & Garside, R. F. (1970). The relationship between the Maudsley Personality Inventory and the course of affective disorders. British Journal of Psychiatry 116, 1119.CrossRefGoogle ScholarPubMed
Kripke, D. F., Simons, R. N., Garfinkel, L. & Hammond, E. C. (1979). Short and long sleep and sleeping pills: is increased mortality associated? Archives of General Psychiatry 36, 103116.CrossRefGoogle Scholar
Murphy, J. M., Monson, R. R., Olivier, D. C., Sobol, A. M. & Leighton, A. H. (1987). Affective disorders and mortality. Archives of General Psychiatry 44, 473480.CrossRefGoogle ScholarPubMed
PaganiniHill, A. & Hsu, G. (1994). Smoking and mortality among residents of a California retirement community. American Journal of Public Health 84, 992995.CrossRefGoogle ScholarPubMed
Parkes, C. M., Benjamin, B. & Fitzgerald, R. G. (1969). Broken heart: A statistical study of increased mortality among widowers. British Medical Journal i, 740743.CrossRefGoogle Scholar
Rorsman, B., Hagnell, O. & Lanke, J. (1982). Mortality in the Lundby study. Neuropsychobiology 8, 188197.CrossRefGoogle ScholarPubMed
Segal, S. P. & Kotler, P. L. (1991). A ten-year perspective of mortality risk among mentally ill patients in sheltered care. Hospital and Community Psychiatry 42, 708713.Google ScholarPubMed
Singer, E., Garfinkel, R., Cohen, S. M. & Srole, L. (1976). Mortality and mental health: evidence from the Midtown Manhattan restudy. Social Science and Medicine 10, 517525.CrossRefGoogle ScholarPubMed
Smith, G. K. (1970). Personality and smoking: a review of the empirical literature. In Learning Mechanisms in Smoking (ed. Hunt, W. A.), pp. 4261. Chicago University Press: Chicago.Google Scholar
WHO (1977). Manual of the International Statistical Classification of Disease, Injuries and Causes of Death. Based on the Recommendations of the Ninth Revision Conference, 1975.WHO Division of Mental Health:Geneva.Google Scholar