TY  - JOUR
PY  - 2018//
TI  - Association between psychological distress and mortality: the case of Israel
JO  - Journal of epidemiology and community health
A1  - Ponizovsky, Alexander Michael
A1  - Haklai, Ziona
A1  - Goldberger, Nehama
SP  - 726
EP  - 732
VL  - 72
IS  - 8
N2  - BACKGROUND: Previous studies have demonstrated the association between psychological distress (measured by the 12-item General Health Questionnaire, GHQ-12) and risks of all-cause mortality and deaths from cardiovascular, cancer and other causes. We hypothesised that in the Israeli population permanently exposed to war/terror stressors, this relationship is absent. <br><br>METHODS: We performed an analysis of data from participants in the Israel National Health Survey conducted in 2003-2004, who died during the follow-up decade. Subjects were assigned to groups based on GHQ-12 score: 0-10 (asymptomatic), 11-14 (subclinically symptomatic), 15-19 (symptomatic) and 20-36 (highly symptomatic). Data were weighted to the total population. <br><br>RESULTS: We analysed data from 4843 individuals, median age 40.5 (IQR 28-54); 473 participants died during the follow-up. We found a significant increase in total mortality, cardiovascular and other causes of mortality (but not cancer deaths) with increase in GHQ-12 score (P for linear trend of ungrouped GHQ scores <0.0001, 0.0015 and <0.0001, respectively). The age-sex-adjusted HR for the highest GHQ-12 compared with the lowest asymptomatic category was 2.1 (95% CI 1.6 to 2.7) for all-cause deaths, 2.3 (95% CI 1.3 to 4.1) for cardiovascular disease deaths and 2.7 (95% CI 1.9 to 3.9) for other deaths. The HR remained significant after adjustment for education, smoking, alcohol consumption and diabetes. The HR even increased after excluding participants with baseline cardiovascular diseases and cancer. <br><br>CONCLUSION: Contrary to our hypothesis, psychological distress was associated with all-cause and cardiovascular but not cancer mortality. The absence of reverse causality provides evidence for the direct deleterious effects of psychological distress on mortality outcomes.<br><br>© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.<p />  <p>Language: en</p>
LA  - en
SN  - 0143-005X
UR  - http://dx.doi.org/10.1136/jech-2017-210356
ID  - ref1
ER  -