Psychological distress, physical illness, and risk of coronary heart disease

Rasul, F., Stansfeld, S.A., Hart, C.L. and Davey Smith, G. (2005) Psychological distress, physical illness, and risk of coronary heart disease. Journal of Epidemiology and Community Health, 59(2), pp. 140-145. (doi: 10.1136/jech.2004.019786)

Abstract

Study objective: The aims of this study are to confirm the association between psychological distress and coronary heart disease (CHD) using an epidemiological community study with hospital admissions data and to examine if any association is explained by existing illness. Design: Prospective cohort study modelling the association between psychological distress, measured using the 30 item general health questionnaire (GHQ), and hospital admissions data for CHD (ICD 410–414), using proportional hazards modelling adjusted for sociodemographic, CHD risk factors, and angina, bronchitis, diabetes, ischaemia, and stroke. Setting: Two suburbs of Glasgow, Renfrew and Paisley, in Scotland. Participants: 6575 men and women aged 45–64 years from Paisley. Main: results: Five year CHD risk in distressed men compared with non-distressed men was 1.78 (95% confidence intervals (CI), 1.15 to 2.75) in age adjusted analysis, 1.78 (95% CI, 1.14 to 2.79) with sociodemographic and CHD risk factor adjustment, and 1.61 (95% CI 1.02 to 2.55) with additional adjustment for existing illness. Psychological distress was unrelated to five year CHD risk in women. In further analysis, compared with healthy, non-distressed men, distressed physically ill men had a greater risk of CHD than non-distressed physically ill men, a relative risk of 4.01 (95% CI 2.42 to 6.66) compared with 2.12 (95% CI 1.35 to 3.32). Conclusion: The association of psychological distress with an increased risk of five year CHD risk in men could be a function of baseline physical illness but an effect independent of physical illness cannot be ruled out. Its presence among physically ill men greatly increases CHD risk.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Davey Smith, Professor George
• Authors: Rasul, F., Stansfeld, S.A., Hart, C.L., and Davey Smith, G.
• Subjects: R Medicine > RC Internal medicine; B Philosophy. Psychology. Religion > BF Psychology
• College/School: College of Medical Veterinary and Life Sciences
• Research Group: Midspan
• Journal Name: Journal of Epidemiology and Community Health
• Publisher: BMJ Publishing Group
• ISSN: 0143-005X
• Copyright Holders: Copyright © 2005 BMJ Publishing Group
• First Published: First published in Journal of Epidemiology and Community Health 59(2):140-145
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher