title: Diagnostic labelling influences self-rated health. A prospective cohort study: the HUNT Study, Norway.
abstract: BACKGROUND
  Studies have shown an independent association between poor self-rated health (SRH) and increased mortality. Few studies, however, have investigated any possible impact on SRH of diagnostic labelling.
  
  
  OBJECTIVE
  To test whether SRH differed in persons with known and unknown hypothyroidism, diabetes mellitus (DM) or hypertension, opposed to persons without these conditions, after 11-year follow-up.
  
  
  METHODS
  Prospective population-based cohort study in North-Trøndelag County, Norway, HUNT2 (1995-97) to HUNT3 (2006-08). All inhabitants aged 20 years and older were invited. The response rate was 69.5% in HUNT2 and 54.1% in HUNT3. In total, 34144 persons aged 20-70 years were included in the study population. The outcome was poor SRH.
  
  
  RESULTS
  Persons with known disease had an increased odds ratio (OR) to report poor SRH at follow-up; figures ranging from 1.11 (0.68-1.79) to 2.52 (1.46-4.34) (men with hypothyroidism kept out owing to too few numbers). However, in persons not reporting, but having laboratory results indicating these diseases (unknown disease), no corresponding associations with SRH were found. Contrary, the OR for poor SRH in women with unknown hypothyroidism and unknown hypertension was 0.64 (0.38-1.06) and 0.89 (0.79-1.01), respectively.
  
  
  CONCLUSIONS
  Awareness opposed to ignorance of hypothyroidism, DM and hypertension seemed to be associated with poor perceived health, suggesting that diagnostic labelling could have a negative effect on SRH. This relationship needs to be tested more thoroughly in future research but should be kept in mind regarding the benefits of early diagnosing of diseases.
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7489 Trondheim and pal.jorgensen@ntnu.no.
authors.forename: Pål
authors.initials: P
authors.lastname: Jørgensen
authors.affiliation: Department of Public Health and General Practice, HUNT Research Centre, Norwegian University of Science and Technology, 7600 Levanger, Norway.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Langhammer
authors.affiliation: Department of Public Health and General Practice, HUNT Research Centre, Norwegian University of Science and Technology, 7600 Levanger, Norway.
authors.forename: Steinar
authors.initials: S
authors.lastname: Krokstad
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7489 Trondheim and.
authors.forename: Siri
authors.initials: S
authors.lastname: Forsmo
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000523:psychology*; D007037:Hypothyroidism / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009664:Norway; D011446:Prospective Studies; D055815:Young Adult
keywords: Cohort; diabetes mellitus; hypertension; hypothyroidism; longitudinal; self-rated health.