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Psychological distress and mortality among US adults: prospective cohort study of 330 367 individuals


Yang, L and Zhao, M and Magnussen, CG and Veeranki, SP and Xi, B, Psychological distress and mortality among US adults: prospective cohort study of 330 367 individuals, Journal of Epidemiology and Community Health, 74, (4) pp. 384-390. ISSN 0143-005X (2020) [Refereed Article]

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Author(s) (or their employer(s)) 2020.

DOI: doi:10.1136/jech-2019-213144


Background: Previous studies have shown inconsistent findings on the association between psychological distress and risk of mortality. This study aimed to address this inconsistent association using a large US population-based cohort.

Methods: This study used data from 1997 to 2009 US National Health Interview Survey, which were linked with National Death Index through 31 December 2011. Psychological distress was measured using Kessler-6 scale and was categorised into six groups based on scores as 0, 1-3, 4-6, 7-9, 10-12 and ≥13. Main outcomes were all-cause, cancer-specific and cardiovascular disease (CVD)-specific mortality. Analyses were completed in 2019. Cox proportional hazards models were used to determine the association between psychological distress and mortality.

Results: A total of 330 367 participants aged ≥18 years were included. During a mean follow-up of 8.2 years, 34 074 deaths occurred, including 8320 cancer-related and 8762 CVD-related deaths. There was a dose-response association between psychological distress and all-cause mortality. Compared with the 0 score category, adjusted HRs (95% CIs) for other categorical psychological distress scores, that is, 1-3, 4-6, 7-9, 10-12 and ≥13, were 1.09 (1.05 to 1.12), 1.22 (1.17 to 1.27), 1.38 (1.31 to 1.46), 1.49 (1.40 to 1.59) and 1.57 (1.47 to 1.68), respectively. Corresponding values for cancer-specific mortality were 1.06 (0.99 to 1.12), 1.13 (1.04 to 1.23), 1.27 (1.14 to 1.42), 1.38 (1.22 to 1.57) and 1.32 (1.15 to 1.51), respectively; those for CVD-specific mortality were 1.11 (1.05 to 1.18), 1.22 (1.12 to 1.32), 1.30 (1.17 to 1.45), 1.38 (1.20 to 1.58), and 1.46 (1.27 to 1.68), respectively.

Conclusions: We found a dose-response relationship between psychological distress and all-cause and cause-specific mortality, emphasising the need for early prevention strategies among individuals with potential psychological distress.

Item Details

Item Type:Refereed Article
Keywords:cohort studies, mental health, mortality, psychological stress
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Mental health
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
ID Code:139628
Year Published:2020
Web of Science® Times Cited:11
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-06-23
Last Modified:2020-07-27

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