Association of stress-related disorders with subsequent risk of all-cause and cause-specific mortality: A population-based and sibling-controlled cohort study

Tian, Fan; Shen, Qing; Hu, Yihan; Ye, Weimin; Valdimarsdóttir, Unnur; Song, Huan; Fang, Fang

doi:10.1016/j.lanepe.2022.100402

Cited by 13 publications

(14 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of the included studies focused specifically on veteran military populations, and only 12 studies analysed civilian populations. Of the civilian studies, two involved participants exposed to war trauma [ 38 , 49 ], two terrorist attacks [ 41 , 51 ], one a natural disaster [ 44 ], and seven included participants exposed to any type of trauma [ 22 , 23 , 45 , 58 – 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…Amongst the studies that measured symptoms or severity of PTSD, two (which presented null findings) were based on a dimensional metric [ 52 , 54 ] (rather than a 0 vs. 1 determination to indicate probable PTSD diagnosis), and were excluded from analyses. An additional article was also excluded from the main meta-analyses [ 22 ] as it utilised the same participants as another study [ 61 ], but was later included in the subgroup analyses investigating causes of death.…”

Section: Resultsmentioning

confidence: 99%

“…One explanation may be due to elevated proinflammatory cytokines (e.g., tumour necrosis factor-α and interleukin-6), and reactive oxygen species, which can occur with neuroendocrine changes in PTSD [ 14 , 74 ], and may be associated with the pathologies of the aforementioned chronic diseases. Nine studies included in this review [ 22 , 43 , 45 , 50 , 57 , 58 , 61 – 63 ] adjusted for physical comorbidities, and four of these studies were not able to indicate excess mortality with PTSD [ 43 , 45 , 50 , 57 ]. Mild traumatic brain injury (mTBI) is one possible illness driving the PTSD/mortality association as this is a common occurrence with PTSD [ 75 ].…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric comorbidities are highly prevalent in PTSD affected individuals, with more than 90% of people with PTSD also having another lifetime mental disorder [ 76 ]. However, only four studies [ 57 , 58 , 61 , 62 ] considered all psychiatric comorbidities in their analyses, and only one of these studies did not demonstrate an increased risk of mortality [ 57 ]. Major Depressive Disorder (MDD) or depressive symptoms, which many of the included studies did not adjust for, may explain the strong association observed with external causes of death, as suicidality risk is increased combined with PTSD [ 77 ].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

Background Posttraumatic Stress Disorder (PTSD) could potentially increase the risk of mortality, and there is a need for a meta-analysis to quantify this association. This study aims to determine the extent to which PTSD is a predictor of mortality. Methods EMBASE, MEDLINE, and PsycINFO were searched systematically on 12th February 2020, with updated searches conducted in July 2021, and December 2022 (PROSPERO CRD42019142971). Studies involving community-dwelling participants with a diagnosis of PTSD or PTSD symptoms, and a comparator group of individuals without PTSD, and which assessed mortality risk, were included. A random-effects meta-analysis was conducted on studies reporting Odds Ratio (OR), Hazard Ratio (HR), and Risk Ratio (RR), and subgroup analysis was also performed by age, sex, type of trauma experienced, PTSD diagnosis, and cause of death. Results A total of 30 eligible studies of mostly good methodological quality were identified, with a total of more than 2.1 million participants with PTSD. The majority of studies involved male-dominated, veteran populations. PTSD was associated with a 47% (95% CI: 1.06–2.04) greater risk of mortality across six studies that reported OR/RR, and a 32% increased risk across 18 studies which reported time to death (HR: 1.32, 95% CI: 1.10–1.59). There was very high study heterogeneity (I2 > 94%) and this was not explained by the prespecified subgroup analysis. Conclusion PTSD is associated with increased mortality risk, however further research is required amongst civilians, involving women, and in individuals from underdeveloped countries.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Stress is defined as the psychological response of the organism to a perceived challenge or threat, occurring when an individual perceives that environmental demands exceed his or her adaptive capacity [5]. Psychological stress is an important modifiable risk factor for mental and physical illnesses, through both health-impairing behaviors and pathophysiological pathways [6][7][8]. Although allostatic load is hard to measure, some instruments have been validated to assess apprehended levels of stress in the widespread population-such as the 10-item perceived stress scale (PSS-10) [9].…”

Section: Introductionmentioning

confidence: 99%

Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study

Romano

Bebars

Орту³

et al. 2023

Clin Oral Invest

View full text Add to dashboard Cite

Objectives The aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT). Materials and methods After the administration of psychological questionnaires, patients diagnosed with generalized stage III–IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT. Results Of the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD. Conclusion Psychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017). Practical implications Based on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies.

show abstract

All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis

Mataix-Cols,

Isomura,

Sidorchuk

et al. 2024

JAMA Psychiatry

View full text Add to dashboard Cite

ImportanceHypochondriasis, also known as health anxiety disorder, is a prevalent, yet underdiagnosed psychiatric disorder characterized by persistent preoccupation about having serious and progressive physical disorders. The risk of mortality among individuals with hypochondriasis is unknown.ObjectiveTo investigate all-cause and cause-specific mortality among a large cohort of individuals with hypochondriasis.Design, Setting, and ParticipantsThis Swedish nationwide matched-cohort study included 4129 individuals with a validated International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis of hypochondriasis assigned between January 1, 1997, and December 31, 2020, and 41 290 demographically matched individuals without hypochondriasis. Individuals with diagnoses of dysmorphophobia (body dysmorphic disorder) assigned during the same period were excluded from the cohort. Statistical analyses were conducted between May 5 and September 27, 2023.ExposureValidated ICD-10 diagnoses of hypochondriasis in the National Patient Register.Main Outcome and MeasuresAll-cause and cause-specific mortality in the Cause of Death Register. Covariates included birth year, sex, county of residence, country of birth (Sweden vs abroad), latest recorded education, civil status, family income, and lifetime psychiatric comorbidities. Stratified Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% CIs of all-cause and cause-specific mortality.ResultsOf the 4129 individuals with hypochondriasis (2342 women [56.7%]; median age at first diagnosis, 34.5 years [IQR, 26.3-46.1 years]) and 41 290 demographically matched individuals without hypochondriasis (23 420 women [56.7%]; median age at matching, 34.5 years [IQR, 26.4-46.2 years]) in the study, 268 individuals with hypochondriasis and 1761 individuals without hypochondriasis died during the study period, corresponding to crude mortality rates of 8.5 and 5.5 per 1000 person-years, respectively. In models adjusted for sociodemographic variables, an increased rate of all-cause mortality was observed among individuals with hypochondriasis compared with individuals without hypochondriasis (HR, 1.69; 95% CI, 1.47-1.93). An increased rate was observed for both natural (HR, 1.60; 95% CI, 1.38-1.85) and unnatural (HR, 2.43; 95% CI, 1.61-3.68) causes of death. Most deaths from unnatural causes were attributed to suicide (HR, 4.14; 95% CI, 2.44-7.03). The results were generally robust to additional adjustment for lifetime psychiatric disorders.Conclusions and RelevanceThis cohort study suggests that individuals with hypochondriasis have an increased risk of death from both natural and unnatural causes, particularly suicide, compared with individuals from the general population without hypochondriasis. Improved detection and access to evidence-based care should be prioritized.

show abstract

Association of stress-related disorders with subsequent risk of all-cause and cause-specific mortality: A population-based and sibling-controlled cohort study

Cited by 13 publications

References 44 publications

Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis

Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis

Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study

All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis

Contact Info

Product

Resources

About