Sense of coherence and psychiatric morbidity: a 19-year register-based prospective study.

BACKGROUND: Most prospective studies on the relationship between sense of coherence (SOC) and mental health have been conducted using subjective health indicators and short-term follow-ups. The objective of this prospective occupational cohort study was to examine whether a strong sense of coherence is a protective factor against psychiatric disorders over a long period of time. METHODS: The study was conducted in a multinational forest industry corporation with domicile in Finland. Participants were 8029 Finnish industrial employees aged 18-65 at baseline (1986). Questionnaire survey data on SOC and other factors were collected at baseline; records of hospital admissions for psychiatric disorders and suicide attempt were derived from the National Hospital Discharge Register, while records of deaths due to suicide were derived from the National Death Registry up until 2006. RESULTS: During the 19-year follow-up, 406 participants with no prior admissions were admitted to hospital for psychiatric disorders (n=351) or suicide attempt (n=25) or committed a suicide (n=30). A strong SOC was associated with about 40% decreased risk of psychiatric disorder. This association was not accounted for by mental health-related baseline characteristics, such as sex, age, marital status, education, occupational status, work environment, risk behaviours or psychological distress. The result was replicated in a subcohort of participants who did not report an elevated level of psychological distress at baseline (hazard ratio=0.59, 95% CI 0.40 to 0.86). CONCLUSIONS: A strong SOC is associated with reduced risk of psychiatric disorders during a long time period.

Sense of coherence and diabetes: a prospective occupational cohort study.

BACKGROUND: Sense of coherence (SOC) is an individual characteristic related to a positive life orientation leading to effective coping. A weak SOC has been associated with indicators of general morbidity and mortality. However, the relationship between SOC and diabetes has not been studied in prospective design. The present study prospectively examined the relationship between a weak SOC and the incidence of diabetes. METHODS: The relationship between a weak SOC and the incidence of diabetes was investigated among 5827 Finnish male employees aged 18-65 at baseline (1986). SOC was measured by questionnaire survey at baseline. Data on prescription diabetes drugs from 1987 to 2004 were obtained from the Drug Imbursement Register held by the Social Insurance Institution. RESULTS: During the follow-up, 313 cases of diabetes were recorded. A weak SOC was associated with a 46% higher risk of diabetes in participants who had been = <50 years of age on entry into the study. This association was independent of age, education, marital status, psychological distress, self-rated health, smoking status, binge drinking and physical activity. No similar association was observed in older employees. CONCLUSION: The results suggest that besides focusing on well-known risk factors for diabetes, strengthening SOC in employees of = <50 years of age can also play a role in attempts to tackle increasing rates of diabetes.