title: Psychological distress, physical illness and mortality risk.
abstract: BACKGROUND
  Psychological distress has been associated with an increased risk of overall and disease-specific mortality risk. This study examines whether the length of follow-up time influences mortality risk.
  
  
  METHODS
  The associations between psychological distress and all-cause and coronary heart disease mortality were modelled using proportional hazards modelling in a prospective cohort study of 6920 men and women aged 45-64 years. Psychological distress was assessed at baseline using the 30-item General Health Questionnaire (GHQ-30).
  
  
  RESULTS
  Psychological distress was associated with a 5-year all-cause mortality (RR 1.68 95% CI 1.07-2.62) and CHD mortality (RR 1.64 95% CI 1.02-2.56) in men after adjustment for sociodemographic and CHD risk factors, but not after further adjustment for baseline physical illness (RR 1.41 95% CI 0.88-2.23) for all-cause mortality (RR 1.39 95% CI 0.88-2.21) for CHD mortality. Psychological distress was not associated with all-cause and CHD mortality at 15- and 20-year follow-up.
  
  
  CONCLUSIONS
  Psychological distress is a reflection of baseline physical illness that increases mortality risk. Psychological distress maybe on the causal pathway between physical illness and mortality risk.
authors.affiliation: Department of Psychiatry, Bart's and The London School of Medicine and Dentistry, Queen Mary, University of London, Mile End Road, London E1 4NS, UK. F.R.Rasul@qmul.ac.uk
authors.forename: Farhat
authors.initials: F
authors.lastname: Rasul
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stansfeld
authors.forename: Carole L
authors.initials: CL
authors.lastname: Hart
authors.forename: Charles R
authors.initials: CR
authors.lastname: Gillis
authors.forename: George Davey
authors.initials: GD
authors.lastname: Smith
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000401:mortality*; D012307:Risk Factors; D012680:Sensitivity and Specificity