Psychological distress may increase mortality risk in US population

Psychological distress was significantly associated with mortality, even after adjusting for potential confounders such as smoking and chronic health conditions, according to a data review from the Substance Abuse and Mental Health Services Administration.

“Mental illness is a major public health issue in the United States because it is associated with increased risk of premature death. Reducing the mortality impact associated with mental illness and increasing life expectancy are important public health goals. To that end, organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Association of State Mental Health Program Directors (NASMHPD) have indicated that monitoring premature mortality attributable to mental illness is crucial to improve the lives of persons with mental illness,” Valerie L. Forman-Hoffman, PhD, MPH, of RTI International, Research Triangle Park, North Carolina, and colleagues wrote.

To examine the relationship between psychological distress and mortality, researchers analyzed data from the National Health Interview Survey from 1997 to 2004. Psychological distress was measured in the month preceding interview and mortality was tracked during follow-up.

An average 3.1% (95% CI, 3-3.2) of adults reported serious psychological distress in the past month.

The age-adjusted death rate was more than twice as high for adults with serious psychological distress compared with adults without serious psychological distress (1,763 vs. 840 per 100,000 person-years).

The cumulative probability of death by the end of follow-up was approximately 0.16 for adults with serious psychological distress and 0.09 for those without distress, according to Kaplan-Meier estimates.

Serious psychological distress remained a significant risk factor for mortality even after controlling for sociodemographic characteristics, chronic health conditions and behavioral risk factors, according to Cox proportional hazard regression models.

Compared with individuals without serious psychological distress, individuals aged 18 to 34 years with serious psychological distress were 2.44 times more likely to have died during follow-up, individuals aged 35 to 54 years were 1.25 times more likely, and those aged 55 years and older were 1.3 times more likely to have died during follow-up.

“The results of this study clearly show that mental illness contributes to premature death in the U.S. household population. Using several mortality-related indices, this study confirms that one measure of mental illness (psychological distress) is a strong predictor of premature death, independent of sociodemographic risk factors and co-occurring physical and behavioral health factors,” Forman-Hoffman and colleagues wrote. “Our study supports previous findings in which 1) the effect of psychological distress on the overall death rate was reduced upon adjustment for demographic and behavioral risk factors and chronic diseases and 2) a relationship exists between levels of psychological distress and the overall death rate.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.

Reference:

Forman-Hoffman VL, et al. U.S. Department of Health and Human Services. CBHSQ report: Psychological distress and mortality among adults in the U.S. household population. Available at: http://www.samhsa.gov/data. Accessed October 26, 2015.