title: Life dissatisfaction as a predictor of fatal injury in a 20-year follow-up.
abstract: OBJECTIVE
  To investigate the role of life satisfaction (LS) in fatal injuries with special references to unintentional injuries and whether health status modifies this relationship.
  
  
  METHODS
  A sample of adult Finns unselected for health status (n=29 173) responded in 1975 to a LS scale. Nationwide registry for deaths was used. The dissatisfied were compared with the satisfied by Cox regression.
  
  
  RESULTS
  During 1976-1995, 469 fatal injuries occurred, of which 235 were unintentional. Dissatisfaction predicted fatal unintentional [hazard ratio (HR)=2.83; 95% confidence interval (CI) 1.77-4.51] and intentional injury (HR=3.26; 2.01-5.30). The risk of fatal unintentional injury was 7.8-fold (women) and 4.0-fold (men) increased in the sick and dissatisfied compared with the healthy and satisfied. A repeatedly reported dissatisfaction (1975, 1981) provided a HR of 5.17 (1.48-18.0) for unintentional injury death during 1981-1995. The found effect was partly mediated through health behavior and social situation.
  
  
  CONCLUSIONS
  Life dissatisfaction predicts both unintentional and intentional injury death.
authors.affiliation: Department of Psychiatry, Kuopio University Hospital, University of Kuopio, Finland. heli.koivumaa@kuh.fi
authors.forename: H
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.forename: R
authors.initials: R
authors.lastname: Honkanen
authors.forename: M
authors.initials: M
authors.lastname: Koskenvuo
authors.forename: H
authors.initials: H
authors.lastname: Viinamäki
authors.forename: J
authors.initials: J
authors.lastname: Kaprio
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D016728:Self-Injurious Behavior / Q000401:mortality*