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Temperament in young adulthood and later mortality: prospective observational study
  1. P McCarron1,
  2. D Gunnell2,
  3. G L Harrison3,
  4. M Okasha2,
  5. G Davey Smith2
  1. 1N Ireland Cancer Registry, Department of Epidemiology and Public Health, The Queen’s University of Belfast, UK
  2. 2Department of Social Medicine, University of Bristol, Bristol, UK
  3. 3Division of Psychiatry, University of Bristol
  1. Correspondence to:
 Dr P McCarron, Department of Epidemiology and Public Health, Queen’s University Belfast, Mulhouse Building, Grosvenor Road, Belfast BT12 6BJ, UK;


Study objective: To determine the association between a clinician assessment of temperament in early adulthood and cause specific mortality.

Design: Prospective observational study.

Setting: Glasgow University.

Participants: 9239 male former students aged 16–30 (mean 20.5) years who participated in an ongoing health survey from 1948–68. A physician recorded free text assessment of temperament, which seemed to capture aspects of personality (trait) and mental health (state), was coded into: stable, anxious, schizoid, hypomanic, odd, depressed, immature, hypochondriacal, unstable, and obsessive. Associations between temperament and mortality were investigated using Cox proportional hazards models.

Main results: There were 878 deaths. Most students—8342 (90.3%)—were assessed as stable, the remaining 897 (9.7%) having at least one, and 103 (1.1%) having more than one, temperament type. The second most common temperament was anxiety, recorded in 520 (5.6%) students. In multivariable analyses, having at least one temperament type was associated with increased all cause and stroke mortality, hazard ratios (95% confidence intervals): 1.23 (1.01 to 1.50) and 1.95 (1.06 to 3.59) respectively, compared with stable students. Students with more than one temperament type had higher risk of death from: all causes, 2.05 (1.36 to 3.09); stroke, 3.26 (1.01 to 10.56); and cancer, 2.90 (1.62 to 5.20). Anxiety was positively associated with all cause and cancer mortality, respective hazard ratios: 1.36 (1.07 to 1.72) and 1.51 (1.04 to 2.20). Men labelled hypomanic had increased cardiovascular mortality risk, 1.90 (1.05 to 3.44).

Conclusions: Markers of early adult psychological distress are associated with increased mortality. Mechanisms underlying these associations require investigation.

  • temperament
  • early life
  • mortality
  • prospective study
  • CHD, coronary heart disease
  • CVD, cardiovascular disease
  • BMI, body mass index

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  • Funding: Chest Heart and Stroke (Scotland), Stroke Association, NHS Management Executive, Cardiovascular Disease and Stroke Research and Development Initiative.

  • Conflicts of interest: none declared.