Psychological distress, physical illness and mortality risk

J Psychosom Res. 2004 Sep;57(3):231-6. doi: 10.1016/S0022-3999(03)00618-4.


Background: Psychological distress has been associated with an increased risk of overall and disease-specific mortality risk. This study examines whether the length of follow-up time influences mortality risk.

Methods: The associations between psychological distress and all-cause and coronary heart disease mortality were modelled using proportional hazards modelling in a prospective cohort study of 6920 men and women aged 45-64 years. Psychological distress was assessed at baseline using the 30-item General Health Questionnaire (GHQ-30).

Results: Psychological distress was associated with a 5-year all-cause mortality (RR 1.68 95% CI 1.07-2.62) and CHD mortality (RR 1.64 95% CI 1.02-2.56) in men after adjustment for sociodemographic and CHD risk factors, but not after further adjustment for baseline physical illness (RR 1.41 95% CI 0.88-2.23) for all-cause mortality (RR 1.39 95% CI 0.88-2.21) for CHD mortality. Psychological distress was not associated with all-cause and CHD mortality at 15- and 20-year follow-up.

Conclusions: Psychological distress is a reflection of baseline physical illness that increases mortality risk. Psychological distress maybe on the causal pathway between physical illness and mortality risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Psychophysiologic Disorders / mortality*
  • Risk Factors
  • Sensitivity and Specificity