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The effects of psychological distress and its interaction with socioeconomic position on risks of developing four chronic diseases.

The effects of psychological distress and its interaction with socioeconomic position on risks of developing four chronic diseases.
The effects of psychological distress and its interaction with socioeconomic position on risks of developing four chronic diseases.
Objective: To examine the relationship between psychological distress and risk of developing arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes across the range of distress severity, investigate the mediating roles of health behaviours and explore whether the associations vary with socioeconomic position.
Methods: Participants were 16,485 adults from the UK Household Longitudinal Study We examined prospective relationships between psychological distress at baseline (measured using the 12-item General Health Questionnaire) and incidence of arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes (measured using self-report) over 3 years using logistic regression. We then examined the mediating effects of health behaviours and investigated whether the associations varied with socioeconomic position.
Results: Distress significantly increased risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern after controlling for age, sex, socioeconomic position, neighbourhood cohesion, marital status, BMI and baseline disease. High levels of distress (GHQ≥7) increased risk of arthritis (OR 2.22; 1.58-2.13), cardiovascular disease (OR 3.06; 1.89-4.98) and chronic obstructive pulmonary disease (OR 3.25; 1.47-7.18). These associations were partially mediated by smoking status but remained significant after controlling for smoking status, diet and exercise. Distress significantly predicted incident diabetes in manual socioeconomic groups only. Effect sizes did not vary with socioeconomic position for arthritis, cardiovascular disease and chronic obstructive pulmonary disease.
Conclusion: Psychological distress increases risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern, even at low and moderate distress levels. Future research should investigate the mediating role of inflammatory biomarkers.
Keywords: psychological distress; depression; arthritis; cardiovascular disease; chronic obstructive pulmonary disease; diabetes.
Abbreviations: BMI=Body Mass Index, COPD=Chronic Obstructive Pulmonary Disease, CVD=Cardiovascular disease, GHQ=General Health Questionnaire, OR=Odds Ratio, SEP=Socioeconomic Position
0022-3999
McLachlan, Kyle J.J.
2a63f964-a5c5-4eb3-b7ba-d1942fd7f00f
Gale, Catharine R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
McLachlan, Kyle J.J.
2a63f964-a5c5-4eb3-b7ba-d1942fd7f00f
Gale, Catharine R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8

McLachlan, Kyle J.J. and Gale, Catharine R. (2018) The effects of psychological distress and its interaction with socioeconomic position on risks of developing four chronic diseases. Journal of Psychosomatic Research. (doi:10.1016/j.jpsychores.2018.04.004).

Record type: Article

Abstract

Objective: To examine the relationship between psychological distress and risk of developing arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes across the range of distress severity, investigate the mediating roles of health behaviours and explore whether the associations vary with socioeconomic position.
Methods: Participants were 16,485 adults from the UK Household Longitudinal Study We examined prospective relationships between psychological distress at baseline (measured using the 12-item General Health Questionnaire) and incidence of arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes (measured using self-report) over 3 years using logistic regression. We then examined the mediating effects of health behaviours and investigated whether the associations varied with socioeconomic position.
Results: Distress significantly increased risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern after controlling for age, sex, socioeconomic position, neighbourhood cohesion, marital status, BMI and baseline disease. High levels of distress (GHQ≥7) increased risk of arthritis (OR 2.22; 1.58-2.13), cardiovascular disease (OR 3.06; 1.89-4.98) and chronic obstructive pulmonary disease (OR 3.25; 1.47-7.18). These associations were partially mediated by smoking status but remained significant after controlling for smoking status, diet and exercise. Distress significantly predicted incident diabetes in manual socioeconomic groups only. Effect sizes did not vary with socioeconomic position for arthritis, cardiovascular disease and chronic obstructive pulmonary disease.
Conclusion: Psychological distress increases risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern, even at low and moderate distress levels. Future research should investigate the mediating role of inflammatory biomarkers.
Keywords: psychological distress; depression; arthritis; cardiovascular disease; chronic obstructive pulmonary disease; diabetes.
Abbreviations: BMI=Body Mass Index, COPD=Chronic Obstructive Pulmonary Disease, CVD=Cardiovascular disease, GHQ=General Health Questionnaire, OR=Odds Ratio, SEP=Socioeconomic Position

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Accepted/In Press date: 11 April 2018
e-pub ahead of print date: 18 April 2018

Identifiers

Local EPrints ID: 419686
URI: https://eprints.soton.ac.uk/id/eprint/419686
ISSN: 0022-3999
PURE UUID: 1707a71e-121a-4334-b03f-96febf9e3eb7
ORCID for Catharine R. Gale: ORCID iD orcid.org/0000-0002-3361-8638

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Date deposited: 19 Apr 2018 16:30
Last modified: 10 Dec 2019 05:27

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