Cohort description: The Danish study of Functional Disorders.

The Danish study of Functional Disorders (DanFunD) cohort was initiated to outline the epidemiology of functional somatic syndromes (FSS) and is the first larger coordinated epidemiological study focusing exclusively on FSS. FSS are prevalent in all medical settings and can be defined as syndromes that, after appropriate medical assessment, cannot be explained in terms of a conventional medical or surgical disease. FSS are frequent and the clinical importance varies from vague symptoms to extreme disability. No well-described medical explanations exist for FSS, and how to delimit FSS remains a controversial topic. The specific aims with the cohort were to test delimitations of FSS, estimate prevalence and incidence rates, identify risk factors, delimitate the pathogenic pathways, and explore the consequences of FSS. The study population comprises a random sample of 9,656 men and women aged 18-76 years from the general population examined from 2011 to 2015. The survey comprises screening questionnaires for five types of FSS, ie, fibromyalgia, whiplash-associated disorder, multiple chemical sensitivity, irritable bowel syndrome, and chronic fatigue syndrome, and for the unifying diagnostic category of bodily distress syndrome. Additional data included a telephone-based diagnostic interview assessment for FSS, questionnaires on physical and mental health, personality traits, lifestyle, use of health care services and social factors, and a physical examination with measures of cardiorespiratory and morphological fitness, metabolic fitness, neck mobility, heart rate variability, and pain sensitivity. A biobank including serum, plasma, urine, DNA, and microbiome has been established, and central registry data from both responders and nonresponders are similarly available on morbidity, mortality, reimbursement of medicine, heath care use, and social factors. A complete 5-year follow-up is scheduled to take place from year 2017 to 2020, and further reexaminations will be planned. Several projects using the DanFunD data are ongoing, and findings will be published in the coming years.

Negative affect is associated with development and persistence of chemical intolerance: a prospective population-based study.

OBJECTIVE: Chemical intolerance (CI) is characterised by negative health effects attributed to a heightened responsiveness to common airborne chemicals. This longitudinal study explored the hypothesised role of negative affect in the development and persistence of CI in a general population. METHODS: A general population sample aged 19 to 72 years was examined in 2006-2008 and again in 2011-2012. Longitudinal data on CI were analysed with the purpose of examining baseline negative affect as a risk factor for having developed CI at 5-year follow-up and for reporting persistent CI. Participants were classified as reporting no signs of CI, having symptoms of CI and as being a likely CI case based on self-reported reactions to 11 common chemical exposures, symptoms related to chemical exposures and daily life adjustments attributed to reactions when exposed to chemicals. RESULTS: A total of 69.4% of the participants who had reported CI at baseline also reported CI at follow-up. In participants with no baseline CI, 15.5% reported CI at follow-up and 18.1% reported symptoms related to chemicals but no daily life adjustments. Baseline negative affect was positively and statistically significantly associated with both development and persistence of CI. CONCLUSIONS: Initial reports of CI were found to be persistent over time, and a considerable proportion of the participants with no CI at baseline reported having developed CI after 5 years. The positive association between negative affect and CI at the 5-year follow-up supports negative affect as a possible risk factor for CI.

Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: the CARTA consortium.

OBJECTIVES: To investigate whether associations of smoking with depression and anxiety are likely to be causal, using a Mendelian randomisation approach. DESIGN: Mendelian randomisation meta-analyses using a genetic variant (rs16969968/rs1051730) as a proxy for smoking heaviness, and observational meta-analyses of the associations of smoking status and smoking heaviness with depression, anxiety and psychological distress. PARTICIPANTS: Current, former and never smokers of European ancestry aged ≥16 years from 25 studies in the Consortium for Causal Analysis Research in Tobacco and Alcohol (CARTA). PRIMARY OUTCOME MEASURES: Binary definitions of depression, anxiety and psychological distress assessed by clinical interview, symptom scales or self-reported recall of clinician diagnosis. RESULTS: The analytic sample included up to 58 176 never smokers, 37 428 former smokers and 32 028 current smokers (total N=127 632). In observational analyses, current smokers had 1.85 times greater odds of depression (95% CI 1.65 to 2.07), 1.71 times greater odds of anxiety (95% CI 1.54 to 1.90) and 1.69 times greater odds of psychological distress (95% CI 1.56 to 1.83) than never smokers. Former smokers also had greater odds of depression, anxiety and psychological distress than never smokers. There was evidence for positive associations of smoking heaviness with depression, anxiety and psychological distress (ORs per cigarette per day: 1.03 (95% CI 1.02 to 1.04), 1.03 (95% CI 1.02 to 1.04) and 1.02 (95% CI 1.02 to 1.03) respectively). In Mendelian randomisation analyses, there was no strong evidence that the minor allele of rs16969968/rs1051730 was associated with depression (OR=1.00, 95% CI 0.95 to 1.05), anxiety (OR=1.02, 95% CI 0.97 to 1.07) or psychological distress (OR=1.02, 95% CI 0.98 to 1.06) in current smokers. Results were similar for former smokers. CONCLUSIONS: Findings from Mendelian randomisation analyses do not support a causal role of smoking heaviness in the development of depression and anxiety.

Cross-sectional associations between the five factor personality traits and leisure-time sitting-time: the effect of general self-efficacy.

BACKGROUND: Leisure-time sitting-time (LTST) is seen as a possible independent risk-factor for physical and mental health, but research on psychological determinants is sparse. Associations between sitting-time and the personality dimensions of neuroticism, extroversion, openness, agreeableness, and conscientiousness, and the role of general self-efficacy (GSE) were investigated. METHODS: A population-based, cross-sectional study was conducted at the Research Centre for Prevention and Health, Denmark, in 2006-08. Men and women (N = 3471) aged 18 to 69, were randomly sampled in the suburbs of Copenhagen. The NEO Five-Factor Inventory, the General Self-Efficacy-Scale, and the Physical Activity Scale 2 were used. RESULTS: Negative associations were found between LTST and extroversion, conscientiousness, and openness, while neuroticism showed a positive association (R2 = .13). The associations with agreeableness became significantly positive, when GSE was included. All 5 associations were mediated by GSE, with mediation proportions between 23%-60%; but with modest effect sizes. CONCLUSIONS: These cross-sectional results indicate that personality traits and GSE could be considered as associates of LTST; but future longitudinal data are necessary to make causal statements and rule out alternative models fitting data.

[Stress and cardiovascular disease]. / Stress og hjerte-kar-sygdom.

Risk factors of cardiovascular disease (CVD) have been studied intensely since the 1950s. Results on stress as a risk factor for CVD have been inconsistent, but mainly positive. The risk is mediated through lifestyle, but more direct physiological mechanisms (e.g. autonomous nervous system and hypothalamic-pituitary-adrenal axis) are also found. Personality and general coping resources influence stress-appraisal, stress-coping and stress-response. Future studies should integrate stress as a cause (stressor), as a subjective reaction (perception), and as a physiological reaction in the same longitudinal studies with repeated measures.

Association between the Five Factor personality traits and perceived stress: is the effect mediated by general self-efficacy?

Ill-health resulting from chronic stress is influenced by personality traits leading to different ways of appraising and coping with life's daily hassles. Using a large population sample the study aimed to investigate possible associations between perceived stress and the personality dimensions of neuroticism, extroversion, openness, agreeableness, and conscientiousness, and to explore the role of general self-efficacy (GSE). A population-based cross-sectional study was conducted at the Research Centre for Prevention and Health, Denmark, in 2006-2008. Men and women (N=3471) aged 18-69, were randomly sampled in the suburbs of Copenhagen. We used the NEO Five-Factor Inventory (NEO-FFI), Cohen's Perceived Stress Scale and the General Self-Efficacy Scale. Negative associations were found between perceived stress and extroversion, conscientiousness, agreeableness, and openness - the latter initially non-significant - whilst neuroticism had a positive association. The associations with agreeableness and openness became positive and significant, respectively, when GSE was included. All five personality-stress models were mediated by GSE, with extroversion and conscientiousness having the strongest mediating effect. The strongest stress-association was found for neuroticism. GSE was shown to change the impact and interpretation of the personality dimensions on perceived stress. These results indicate that GSE is an important factor to consider in the link between personality and perceived stress.