Temperament as a potential predictor of mortality: evidence from a 41-year prospective study.
Psychological factors were hypothesized to influence mortality, in particular, early versus later mortality. To explore the relationship between temperament, a psychological factor, and mortality in a prospective study of 1337 medical students, we constructed a measure portraying three temperament types, using latent class analysis. Death occurred in 113 subjects over 25-41 years of follow-up. In univariate survival analysis, subjects tending to direct tension "inward" when under stress ("Tension-In") had a higher risk of mortality than "Tension-Out" or "Stable" types. These associations persisted after adjustment for age, smoking, cholesterol level, and Quetelet Index. The relative risk (RR) of mortality for Tension-In was 1.56 (95% confidence interval, 1.00-2.44) compared with the Stable group. The risk was due entirely to the excess risk in persons under 55 years of age (RR, 2.59; 95% confidence interval, 1.46-4.62); the corresponding risk of death in older persons was 0.66 (0.30-1.48). Thus temperament is a significant risk factor for mortality, in particular, premature death.
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
P L
PL
Graves
L A
LA
Mead
N Y
NY
Wang
K Y
KY
Liang
M J
MJ
Klag
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000401:mortality* / Q000523:psychology; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications; D016019:Survival Analysis; D013694:Temperament