The effects of psychological distress and its interaction with socioeconomic position on risk of developing four chronic diseases

Publication type

Journal Article

Published in

Journal of Psychosomatic Research

Authors

Kyle J. J. McLachlan and Catharine R. Gale

Publication date

Summary

Objective: To examine the relationship between psychological distress and risk of developing arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes across the range of distress severity, investigate the mediating roles of health behaviours and explore whether the associations vary with socioeconomic position. Methods: Participants were 16,485 adults from the UK Household Longitudinal Study We examined prospective relationships between psychological distress at baseline (measured using the 12-item General Health Questionnaire) and incidence of arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes (measured using self-report) over 3 years using logistic regression. We then examined the mediating effects of health behaviours and investigated whether the associations varied with socioeconomic position. Results: Distress significantly increased risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern after controlling for age, sex, socioeconomic position, neighbourhood cohesion, marital status, BMI and baseline disease. High levels of distress (GHQ ≥ 7) increased risk of arthritis (OR 2.22; 1.58–2.13), cardiovascular disease (OR 3.06; 1.89–4.98) and chronic obstructive pulmonary disease (OR 3.25; 1.47–7.18). These associations were partially mediated by smoking status but remained significant after controlling for smoking status, diet and exercise. Distress significantly predicted incident diabetes in manual socioeconomic groups only. Effect sizes did not vary with socioeconomic position for arthritis, cardiovascular disease and chronic obstructive pulmonary disease. Conclusion: Psychological distress increases risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern, even at low and moderate distress levels. Future research should investigate the mediating role of inflammatory biomarkers.

Volume and page numbers

109, 79-85

DOI

https://doi.org/10.1016/j.jpsychores.2018.04.004

ISSN

16

Subjects

Psychology, Well Being, Health and Social Stratification

Notes

Open Access; Open Access funded by Medical Research Council; Under a Creative Commons license

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