Social position and functional somatic disorders: The DanFunD study.

BACKGROUND AND AIM: It is generally accepted that functional somatic disorders (FSDs) are a product of biological, psychological, and social factors. Social position might be part of this complex, but the literature on this issue is currently heterogeneous and inconsistent. The aim of the present study was - in a population-based cohort - to test the hypothesis that lower social position would be associated with higher a risk of FSD. METHOD: The association between social position and FSD was examined in a cross-sectional study with various measures of social position (education as measured by vocational training; employment; cohabitation; subjective social status) and delimitations of FSD (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, bodily distress syndrome, and symptom profiles). The associations were analyzed using logistic regressions to calculate odds ratios and 95% confidence intervals. Each social measure was analyzed independently and was adjusted for age and sex. RESULTS: Lower levels of vocational training, being unemployed, and living alone were associated with higher risk of FSD, regardless of the FSD delimitation. There was also a significant negative association between subjective evaluated social status and FSD. The associations remained after multiple adjustments, and seemed to be strongest for the more severe FSD-types. CONCLUSIONS: Lower social position is associated with higher risk of FSD, especially the more severe FSD delimitations, which might constitute an especially vulnerable group. However, the mechanisms behind the relations remain unknown.

Mental vulnerability and survival after cancer.

BACKGROUND: It has been hypothesized that personality traits affect survival after cancer, but studies have produced inconsistent results. This study examined the association between mental vulnerability and survival after cancer in Denmark in a prospective cohort study. METHODS: Between 1976 and 2001, 12733 residents of Copenhagen completed a questionnaire eliciting information on a 12-item mental vulnerability scale, as well as various personal data. Follow-up in the Danish Cancer Registry until 2003 identified 884 incident cases of primary cancer, and follow-up for death from the date of cancer diagnosis until 2003 identified 382 deaths. Mental vulnerability scores were divided into 4 approximately equal-sized groups. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) of all-cause mortality. RESULTS: Multivariate HR for all-cause mortality for persons in the highest category of mental vulnerability compared with those at the lowest was 1.1 (95% confidence interval = 0.9-1.5). CONCLUSION: We found no support for the hypothesis that mental vulnerability is associated with survival after cancer diagnosis.