Neuroticism and cardiovascular disease mortality: socioeconomic status modifies the risk in women (UK Health and Lifestyle Survey).

OBJECTIVE: The association between personality traits and mortality might differ as a function of socioeconomic status (SES). Our aim was to evaluate the all-cause, cardiovascular disease (CVD), and cancer mortality risk associated with neuroticism or extraversion and their interactions with SES in a representative sample of the UK adult population. METHODS: A total of 5450 participants (2505 men) from the Health and Lifestyle Survey completed the Eysenck Personality Inventory at baseline and were monitored for vital status over 25 years. SES was defined as a latent variable comprising occupational social class, educational attainment, and income. RESULTS: A significant neuroticism-by-SES-by-sex interaction (p = .04) for CVD mortality revealed a neuroticism-by-SES interaction specific to women. Compared to women with average SES, those with both high neuroticism and low SES were at an increased risk for CVD mortality (hazard ratio = 2.02, 95% confidence interval = 1.45-2.80), whereas those with high neuroticism and high SES combined were at a decreased risk for CVD mortality (hazard ratio = 0.61, 95% confidence interval = 0.38-0.97, p for interaction = 0.003). The interaction term was not explained by health behaviors (10% attenuation) and physiological variables (11% attenuation). This interaction was not observed for all-cause and cancer mortality risks or among men for CVD mortality. CONCLUSIONS: High neuroticism is a risk factor for cardiovascular mortality in women with low SES, whereas in women with higher SES, it is protective. Further research is needed to replicate this finding and identify the mechanisms behind the modifying effect of SES on neuroticism.

[Comorbide somatic pathology in servicemen with neurotic disorders].

Prevalence and structure of comorbidity a somatic pathology in military men with neurotic disorders was studied. It was established that 40,4% of surveyed noted concomitant somatic pathology, the structure of which was dominated by gastro-intestinal tract (26,8%), and pathology of the cardiovascular system (21,6%). It is shown that concomitant somatic pathology provided aggravating effect on clinic neurotic disorders in serviceman, making it difficult to diagnose mental disorders. The greatest risk concomitant a somatic pathology was marked in patients with depressive and somatoform disorders. Indicates the need for specialized standards of care for persons with comorbid mental and somatic disorders.

Pessimistic, anxious, and depressive personality traits predict all-cause mortality: the Mayo Clinic cohort study of personality and aging.

OBJECTIVE: To study the association between several personality traits and all-cause mortality. METHODS: We established a historical cohort of 7216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965, and who resided within a 120-mile radius centered in Rochester, MN. A total of 7080 subjects (98.1%) were followed over four decades either actively (via a direct or proxy telephone interview) or passively (via review of medical records or by obtaining their death certificates). We examined the association of pessimistic, anxious, and depressive personality traits (as measured using MMPI scales) with all-cause mortality. RESULTS: A total of 4634 subjects (65.5%) died during follow-up. Pessimistic, anxious, and depressive personality traits were associated with increased all-cause mortality in both men and women. In addition, we observed a linear trend of increasing risk from the first to the fourth quartile for all three scales. Results were similar in additional analyses considering the personality scores as continuous variables, in analyses combining the three personality traits into a composite neuroticism score, and in several sets of sensitivity analyses. These associations remained significant even when personality was measured early in life (ages 20-39 years). CONCLUSIONS: Our findings suggest that personality traits related to neuroticism are associated with an increased risk of all-cause mortality even when they are measured early in life.

Predictive validity of the total health index for all-cause mortality assessed in the Komo-Ise cohort.

BACKGROUND: The Total Health Index (THI), a self-administered questionnaire developed in Japan, is used for symptom assessment and stress management of employees and others; however, it has not been reported whether it can predict mortality risk. METHODS: The THI, with 12 primary and 5 secondary scales, was applied to a cohort consisting of middle-aged residents in Japan. This study, called the Komo-Ise cohort study, was started in 1993. The scale scores were related to 481 deaths from all causes among 10,816 residents over 93 months. The statistics were tested by the Cox hazard model and adjusted for three background variables (sex, age, and district where the subject resided). RESULTS: Five of the scales [depression and aggression (primary scales), and psychosomatics, neurotics, and schizophrenics (secondary scales)] indicated significant hazard ratios for mortality. The lowest quintile group of the aggression scale score had the largest hazard ratio of 2.58, compared with the middle quintile group (95% confidence interval: 1.88-3.52). The psychosomatics, neurotic scales and depression scales also had a minimum hazard ratio in the middle quintile group. One of the secondary scales, T1, which represents a somatoform disorder, had a significant linear relationship with the mortality risk, although its proportionality with the cumulative mortality rates was not satisfactory. CONCLUSIONS: Five scales of the THI were significantly related to mortality risk in the Komo-Ise cohort, which could be used for score evaluation and in the personal health advice system of the THI.

Neuroticism, extraversion, and mortality in the UK Health and Lifestyle Survey: a 21-year prospective cohort study.

OBJECTIVE: To examine the influence of neuroticism and extraversion on all-cause and cause-specific mortality over 21 years after controlling for risk factors. METHODS: Participants were members of the Health and Lifestyle Survey, a British nationwide sample survey of 9003 adults. At baseline (1984 to 1985), individuals completed a sociodemographic and health questionnaire, underwent physical health examination, and completed the Eysenck Personality Inventory. Mortality was assessed for 21 years after baseline. A total of 5424 individuals had complete data. RESULTS: After controlling for age and gender, 1-standard deviation (SD) increase in neuroticism was related to 9% (hazard ratio (HR) = 1.09; 95% Confidence Interval (CI) = 1.03-1.16) increased risk of mortality from all causes. The association was nonsignificant (HR = 1.05; 95% CI = 0.99-1.11) after additionally controlling for occupational social class, education, smoking, alcohol consumption, physical activity, and health. There was 12% (HR = 1.12; 95% CI = 1.03-1.21) increased risk of death from cardiovascular disease associated with 1-SD increase in neuroticism. This was still significant after adjustment. When the sample was divided into 40- to 59-year-olds and those >or=60 years, neuroticism remained a significant risk for all-cause mortality and cardiovascular disease mortality; associations were nonsignificant after controlling for all covariates. Neuroticism was not associated with deaths from stroke, respiratory disease, lung cancer, or other cancers. Extraversion was protective of death from respiratory disease (HR = 0.84; 95% CI = 0.70- 1.00). CONCLUSIONS: After controlling for several risk factors, high neuroticism was significantly related to risk of death from cardiovascular disease. The effects of neuroticism on death from cardiovascular disease may be mediated by sociodemographic, health behavior, and physiological factors.

A twin study of mortality in schizophrenia and neurosis.

This report examines mortality rates in the National Academy of Sciences--National Research Council Twin Registry for twins with recorded diagnoses of schizophrenia or neurosis. The standardized mortality ratio for schizophrenia was 1.77 and resulted from elevations in both traumatic and disease-related deaths. In neurosis, the standardized mortality ratio was 1.30 and was due nearly entirely to elevated rates of disease-related deaths. The pattern of mortality in monozygotic and dizygotic pairs discordant for schizophrenia and neurosis was consistent with the following hypotheses: mortality in both disorders cannot be due to the disease state per se; disease-related mortality in schizophrenia results largely from environmental factors shared by twin pairs; and mortality from trauma in schizophrenia and from diseases in neurosis results largely from genetic factors. These findings must be interpreted in the context of the limitations of the registry, which include lack of standardization and incomplete ascertainment of psychiatric disorders. A review of a subsample of records indicates that schizophrenia in the registry is broadly defined and differs considerably from the narrow DSM-III concept of the disorder.

Suicide and psychiatric patients.

The social and psychiatric risk factors associated with suicide in patients with different psychiatric disorders are reviewed. Suicide among emergency room attenders, inpatients, and outpatients is considered. The assessment and treatment of suicidal patients and the prediction and prevention of suicide are discussed.

Neurosis and mortality: investigating an association.

Neurosis is not a cause of death, but at follow-up neurotic patients are found to experience increased premature mortality. Suicide and accidental death are considerably increased in this group. There is also an excess of deaths from natural causes; amongst hypotheses to account for this there is some evidence to incriminate arteriosclerosis, and increased toxicity from cigarette smoke may be a factor. The increased mortality is not explained by confusion over the term depression. Those neurotic patients who subsequently die are more likely to have suffered from a more severe degree of neurosis at the time of initial treatment.

[Evaluation of mortality in hospitalized mental patients 1968-1982]. / Evolution de la mortalité des malades mentaux hospitalisés 1968-1982.

Yearly, between 1968 and 1976, and every two years from 1976 to 1982, diagnostic data based on a national classification of mental disorders were homogeneously collected in French public psychiatric hospitals. The hospitalized population was estimated by the person-year method, using data on length of stay. The number of observed deaths was compared with the number of deaths expected (Standardized mortality ratio). The standardized mortality ratio (SMR) for psychiatric inpatients were found irregularly and slightly decreasing, except among women under 45: this SMR was higher in 1982 (9.6) than in 1968 (7.4). The SMR for neuroses, in the under 55 years age group, showed a regular increase especially among women. The SMR for psychoses and mental retardation was decreasing among men. For people aged more than 55 years the SMR was decreasing for all groups of diagnosis.

Long-term outcome of patients with neurotic illness in general practice.

OBJECTIVE: To determine the 11 year outcome of neurotic disorder in general practice. DESIGN: Cohort study over 11 years. SETTING: Two general practices in Warwickshire England. SUBJECTS: 100 patients selected to be representative of those identified nationally by general practitioners as having neurotic disorders. MAIN OUTCOME MEASURES: Mortality, morbidity, and use of health services. RESULTS: At 11 years 87 subjects were traced. The 11 year standardised mortality ratio was 173 (95% confidence interval 164 to 200). 47 were cases on the general health questionnaire, 32 had a relapsing or chronic psychiatric course, and 49 a relapsing or chronic physical course. Treatment for psychiatric illness was mainly drugs. The mean number of consultations per year was 10.8 (median 8.7). A persistent psychiatric diagnosis at one year follow up was associated with high attendance ( > 12 visits a year for 11 years) at follow up after age, sex, and physical illness were adjusted for. Severity of psychiatric illness (general health questionnaire score) at outset predicted general health questionnaire score at 11 year follow up, course of psychiatric illness, and high consultation rate. CONCLUSION: These data support the view that a neurotic illness can become chronic and is associated with raised mortality from all causes and high use of services. Such patients need effective intervention, particularly those with a more severe illness who do not recover within one year.

[The correlation of stress and neurosis vulnerability in the structure of nonspecific resistance to extreme factors in intact and pregnant rats]. / O sootnoshenii stress- i nevrozouiazvimosti v strukture nespetsificheskoi rezistentnosti k ékstremal'nym faktoram u intaktnykh i beremennykh krys.

White male rats, intact and pregnant females were subjected for 3 days to deprivation of paradoxical sleep by the technique of Jouvet. The main resulting vectors of the extreme state outcome, i.e., lethality, susceptibility to stress, and neurotization, made it possible to establish corresponding levels of resistance. A relationship of each of the levels with the ability to form conditioned reflexes, initial functional interhemispheric asymmetry and behavioural status, expression of protective reactions and paradoxical sleep under conditions of an insoluble conflict situation was followed. High resistance of pregnant rats is considered to be associated with the formation of gestational ambilaterality of the brain of intact animals. Such an increase in resistance is selective as far as it concerns the organism of the pregnant and it does not ensure stability of the feto-maternal complex under extreme conditions. It was established that there was an inverse relationship between the expression of neurotic disorders of the higher nervous activity and vegeto-morphological features of acute stress. This gives reason to define more exactly the role of neurotic disorders in the pathogenesis of stress and mechanisms of resistance to extreme factors.

[Frequency of suicidal acts in psychoses]. / K voprosu o chastote suitsidal'nykh deistvii pri psikhozakh.

Psychotic patients committing suicide constitute about 10,0% of all the suicide population and not more than 2,0% of all mental patients. Accomplished suicides are committed by mentally ill and psychotic patients 26 times more frequently than suicides without psychoses, and more frequently in the initial phase of the disease. The highest suicidal activity is seen in alcoholic psychoses and psychoses with anxious-depressive syndromes.

[Physical and psychological status of 60-70-year-old citizens of Bern with neurotic symptoms in childhood--a study over more than 50 years (Emmental cohort)]. / Körperliches und psychisches Befinden bei 60-70jährigen Bernerinnen und Bernern mit neurotischen Symptomen im Kindesalter--Eine Untersuchung über mehr als 50 Jahre (Emmental-Kohorte).

The present study was undertaken to assess the influence of childhood variables (physical and emotional) to later well-being in a group of rural Swiss (Emmental Cohort). Our study is the first prospective cohort over a time period of more than 50 years. It includes 1537 children who were listed and assessed in 1942 (T1) because they had difficulties in school or were otherwise behaviorally disturbed. In 1995 (T2) more than 60% of the initial population could be reassessed by our study group. We found more subjects at T2 who had been rated as intelligent at T1. More subjects responding to T2 belonged to a higher social class, were more anxious, and had more psychosocial problems at T1. Social income at T2 is correlated to the social class at T1. More subjects have died since who were rated at T1 as being less intelligent, less neurotical, and having higher psychosocial problems. Twice as many men died than women. The emotional situation at T2 is significantly correlated to psychological well-being at T1. The somatic complaints at T2 correlate significantly to neurotic symptoms in childhood (T1). The more intelligent the children were rated at T1, the less emotional and somatic complaints were voiced at T2 and the better the psychic well-being was rated (T2). In addition, the former social milieu (T1) significantly determined somatic and psychological complaints at T2. Our data discern a significant correlation between actual status and former childhood variables more than 50 years later in a rural Swiss cohort (Emmental Cohort).

Recovered or dead? A Swedish study of 321 persons surveyed as severely mentally ill in 1995/96 but not so ten years later.

AIM: The aim was to follow-up a group of persons who were considered severely and persistently mentally ill (SMI) at the time of the 1995 Swedish mental health-care reform but not so ten years later. METHODS: Surveys were conducted in 1995/96 and 2006 in an area of Sweden. Of 602 persons surveyed as SMI in 1995/96, 321 were not found to be so in a similar survey in 2006. These persons were followed up concerning death rates and causes, as well as concerning recovery and present care. Comparisons between subgroups were made using the results of interviews conducted in 1995/96. RESULTS: Nineteen percent of the persons considered SMI in 1995/96 were recovered in 2006 in the sense that they no longer were considered SMI. The only variable found to predict recovery was diagnosis. Half of the persons in the sample given a diagnosis of neurosis were recovered but only 6% of those given a diagnosis of psychosis. Death rates and death causes seemed to be in line with previous research. CONCLUSIONS: Relatively few persons were considered recovered after ten years. Most persons in the sample were still in contact with care and services.