HRs (95% CI) for psychological distress in relation to cause-specific mortality: UK Biobank (N=308 721)
| Distress categories | |||||
|---|---|---|---|---|---|
| 1 (N=128 505) | 2 (N=112 635) | 3 (N=67 581) | p Value for trend | SD increase in distress | |
| Total (4334 deaths) | |||||
| Age-adjusted and sex-adjusted | 1.0 (ref) | 1.22 (1.14 to 1.31) | 1.77 (1.64 to 1.91) | <0.0001 | 1.23 (1.20 to 1.26) |
| Age-adjusted, sex-adjusted and neuroticism-adjusted | 1.0 | 1.28 (1.19 to 1.38) | 2.01 (1.84 to 2.20) | <0.0001 | 1.30 (1.26 to 1.34) |
| Age-adjusted, sex-adjusted and health behaviours-adjusted | 1.0 | 1.16 (1.09 to 1.25) | 1.49 (1.38 to 1.61) | <0.0001 | 1.14 (1.11 to 1.18) |
| Age-adjusted, sex-adjusted and physical attributes-adjusted | 1.0 | 1.18 (1.10 to 1.27) | 1.60 (1.48 to 1.72) | <0.0001 | 1.18 (1.15 to 1.21) |
| Age-adjusted, sex-adjusted and existing disease-adjusted | 1.0 | 1.15 (1.07 to 1.23) | 1.57 (1.45 to 1.69) | <0.0001 | 1.18 (1.15 to 1.21) |
| Age-adjusted, sex-adjusted and SES-adjusted | 1.0 | 1.23 (1.15 to 1.32) | 1.72 (1.59 to 1.85) | <0.0001 | 1.21 (1.18 to 1.24) |
| Multiply-adjusted | 1.0 | 1.16 (1.08 to 1.25) | 1.54 (1.40 to 1.68) | <0.0001 | 1.16 (1.12 to 1.20) |
| Cancer (2807 deaths) | |||||
| Age-adjusted and sex-adjusted | 1.0 (ref) | 1.19 (1.10 to 1.29) | 1.59 (1.44 to 1.75) | <0.0001 | 1.17 (1.13 to 1.21) |
| Age-adjusted, sex-adjusted and neuroticism-adjusted | 1.0 | 1.27 (1.16 to 1.36) | 1.90 (1.69 to 2.12) | <0.0001 | 1.25 (1.20 to 1.31) |
| Age-adjusted, sex-adjusted and health behaviours-adjusted | 1.0 | 1.14 (1.05 to 1.24) | 1.38 (1.25 to 1.52) | <0.0001 | 1.10 (1.07 to 1.14) |
| Age-adjusted, sex-adjusted and physical attributes-adjusted | 1.0 | 1.17 (1.07 to 1.27) | 1.50 (1.36 to 1.65) | <0.0001 | 1.14 (1.10 to 1.19) |
| Age-adjusted, sex-adjusted and existing disease-adjusted | 1.0 | 1.13 (1.04 to 1.23) | 1.46 (1.32 to 1.61) | <0.0001 | 1.14 (1.10 to 1.18) |
| Age-adjusted, sex-adjusted and SES-adjusted | 1.0 | 1.19 (1.09 to 1.30) | 1.55 (1.41 to 1.70) | <0.0001 | 1.16 (1.12 to 1.20) |
| Multiply-adjusted | 1.0 | 1.16 (1.07 to 1.28) | 1.54 (1.37 to 1.72) | <0.0001 | 1.15 (1.10 to 1.20) |
| Cardiovascular disease (890 deaths) | |||||
| Age-adjusted and sex-adjusted | 1.0 (ref) | 1.25 (1.08 to 1.46) | 1.85 (1.56 to 2.18) | <0.0001 | 1.27 (1.20 to 1.34) |
| Age-adjusted, sex-adjusted and neuroticism-adjusted | 1.0 | 1.31 (1.12 to 1.54) | 2.09 (1.71 to 2.55) | <0.0001 | 1.34 (1.25 to 1.34) |
| Age-adjusted, sex-adjusted and health behaviours-adjusted | 1.0 | 1.17 (1.00 to 1.36) | 1.40 (1.18 to 1.66) | <0.0001 | 1.13 (1.07 to 1.20) |
| Age-adjusted, sex-adjusted and physical attributes-adjusted | 1.0 | 1.18 (1.01 to 1.37) | 1.53 (1.29 to 1.82) | <0.0001 | 1.18 (1.11 to 1.25) |
| Age-adjusted, sex-adjusted and existing disease-adjusted | 1.0 | 1.13 (0.97 to 1.32) | 1.47 (1.24 to 1.75) | <0.0001 | 1.17 (1.10 to 1.24) |
| Age-adjusted, sex-adjusted and SES-adjusted | 1.0 | 1.26 (1.08 to 1.47) | 1.76 (1.48 to 2.08) | <0.0001 | 1.24 (1.17 to 1.31) |
| Multiply-adjusted | 1.0 | 1.13 (0.96 to 1.32) | 1.32 (1.07 to 1.65) | 0.009 | 1.11 (1.03 to 1.20) |
| External (406 deaths) | |||||
| Age-adjusted and sex-adjusted | 1.0 (ref) | 1.17 (0.92 to 1.48) | 2.06 (1.62 to 2.62) | <0.0001 | 1.31 (1.21 to 1.41) |
| Age-adjusted, sex-adjusted and neuroticism-adjusted | 1.0 | 1.16 (0.91 to 1.48) | 2.01 (1.51 to 2.69) | <0.0001 | 1.31 (1.20 to 1.34) |
| Age-adjusted, sex-adjusted and health behaviours-adjusted | 1.0 | 1.12 (0.88 to 1.41) | 1.73 (1.35 to 2.21) | <0.0001 | 1.22 (1.12 to 1.32) |
| Age-adjusted, sex-adjusted and physical attributes-adjusted | 1.0 | 1.13 (0.89 to 1.43) | 1.85 (1.45 to 2.37) | <0.0001 | 1.26 (1.16 to 1.36) |
| Age-adjusted, sex-adjusted and existing disease-adjusted | 1.0 | 1.09 (0.86 to 1.38) | 1.77 (1.39 to 2.27) | <0.0001 | 1.24 (1.15 to 1.35) |
| Age-adjusted, sex-adjusted and SES-adjusted | 1.0 | 1.17 (0.93 to 1.49) | 1.97 (1.56 to 2.51) | <0.0001 | 1.28 (1.18 to 1.38) |
| Multiply-adjusted | 1.0 | 1.06 (0.83 to 1.36) | 1.53 (1.14 to 2.06) | 0.009 | 1.17 (1.06 to 1.29) |
Multiple adjustment is adjustment for the following covariates: health behaviours (smoking status, alcohol intake frequency, number of types of physical activity performed in last month, whether five or more portions of fruit and vegetables eaten per day); physical attributes (body mass index, systolic blood pressure, forced expiratory volume in 1 min, grip strength); existing disease (diagnoses of vascular or heart problems, diabetes, cancer, asthma, chronic lung disease, deep vein thrombosis or pulmonary embolism at baseline) and socioeconomic status (highest educational qualification).
One SD in psychological distress is 2.0 units; a higher distress category denotes greater distress.
SES, socioeconomic status.