Hopelessness and Risk of Mortality and Incidence of Myocardial Infarction and Cancer

Abstract

We examined the relationship among low, moderate, and high levels of hopelessness, all-cause and cause-specific mortality, and incidence of myocardial infarction (MI) and cancer in a population-based sample of middle-aged men. Participants were 2428 men, ages 42 to 60, from the Kuopio Ischemic Heart Disease study, an ongoing longitudinal study of unestablished psychosocial risk factors for ischemic heart disease and other outcomes. In 6 years of follow-up, 174 deaths (87 cardiovascular and 87 noncardiovascular, including 40 cancer deaths and 29 deaths due to violence or injury), 73 incident cancer cases, and 95 incident MI had occurred. Men were rated low, moderate, or high in hopelessness if they scored in the lower, middle, or upper one-third of scores on a 2-item hopelessness scale. Age-adjusted Cox proportional hazards models identified a dose-response relationship such that moderately and highly hopeless men were at significantly increased risk of all-cause and cause-specific mortality relative to men with low hopelessness scores. Indeed, highly hopeless men were at more than three-fold increased risk of death from violence or injury compared with the reference group. These relationships were maintained after adjusting for biological, socioeconomic, or behavioral risk factors, perceived health, depression, prevalent disease, or social support. High hopelessness also predicted incident MI, and moderate hopelessness was associated with incident cancer. Our findings indicate that hopelessness is a strong predictor of adverse health outcomes, independent of depression and traditional risk factors. Additional research is needed to examine phenomena that lead to hopelessness.

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

“…Also, depressive symptoms that are not sufficient in magnitude to meet the criteria for major depression occur at least as commonly among cardiac patients. 2,3 Recent epidemiological studies evaluating the relationship between depression and CAD among healthy [3][4][5][6][7][8][9][10][11] and CAD [12][13][14][15][16][17][18][19] populations consistently demonstrate a significant prospective relationship between the occurrence of major depression episodes and the incidence of cardiac events (Table 1). Two additional findings are notable.…”

Psychosocial influences on the development and course of coronary heart disease: Current status and implications for research and practice.

“…Studies of initially healthy populations have shown that symptoms of depression and anxiety and reports of hopelessness predict future coronary events (i.e., MI, coronary death), even with statistical controls for health behavior (e.g., smoking) and other potential confounding factors (Anda et al, 1993;Ariyo et al, 2000;Aromaa et al, 1994;Barefoot & Schroll, 1996;Eaker, Pinsky, & Castelli, 1992;Everson et al, 1996;Everson, Roberts, Goldberg, & Kaplan, 1998;Ford et al, 1998;Jonas & Mussolino, 2000;Kawachi, Colditz, Ascherio, Rimm, & Giovannucci, 1994;Kubzansky et al, 1997;Penninx et al, 2001;Pratt et al, 1996).…”

Involvement of psychosocial factors in the association of obesity with periodontitis

“…Hopelessness, defined as negative expectancies about oneself and the future, was measured by two items used in the Kupio Heart Disease Study (28)(29)(30). These items were "I feel that it is impossible to reach the goals I would like to strive for" and "The future seems to me to be hopeless, and I can't believe that things are changing for the better".…”