Psychological distress measured by the GHQ-12 and mortality: a prospective population-based study

Abstract

Aims: To examine whether persons with psychological distress have a greater risk of all-cause mortality in the Scandinavian population; whether this association is gender-specific; and what is the influence of socioeconomic status, body mass index (BMI) and health behaviour in this association.

Methods: A total of 923 (414 male and 509 female) people, aged 36 to 56 years, participated in a population-based study from 1997-98 in Pieksämäki, Finland. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 points were summed to a global score ranging from 0-12. Mortality data until 31 December 2009 were drawn from the national mortality register.

Results: There were 44 death events (27 men, 17 women) during the mean observation time of 11 years. The hazard ratio (HR) increased by 16% for every GHQ-12 point (gender and age adjusted HR 1.16, 95% confidence interval (95% CI): 1.07-1.25, p < 0.001). In the fully adjusted model with gender, age, socioeconomic status, BMI, smoking and physical activity, HR was 1.13 (95% CI: 1.04-1.22, p = 0.003). In men, the 10-year survival for distressed (GHQ-12 score ≥ 4) participants was 84% (95% CI: 73- 91) and for non-distressed (GHQ-12 score 0-3) participants it was 96% (95% CI: 93-97), HR = 3.38 (95% CI: 1.55-7.39, p = 0.002). Among women, no significant association was found.

Conclusions: Psychological distress measured by the GHQ-12 is associated with all-cause mortality risk during an 11-year observation time. This is mainly due to excess mortality among distressed men.