Psychological distress and C-reactive protein: Do health behaviours and pathophysiological factors modify the association?

Centre for Social and Health Services,Kuopio, Finland.
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.53). 06/2011; 261(4):277-84. DOI: 10.1007/s00406-010-0134-x
Source: PubMed


The objective of this study is to examine the association of psychological distress to high-sensitivity C-reactive protein (hsCRP) levels and to examine the potential mediating role of health behaviours and pathophysiological factors. A total of 883 (393 men and 490 women) subjects, aged 36-56 years, participated in a population-based, cross-sectional study from 1997 to 1998 in Pieksämäki, Finland. Various clinical, biochemical and behavioural factors were measured, including hsCRP concentration. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). Subjects with low psychological distress (0 points in GHQ-12) were younger and more physically active, and their mean hsCRP level was lower when compared to subjects with medium (1-3 points) or high (4-12 points) psychological distress (1.26 ± 1.36, 1.53 ± 1.75 and 1.70 ± 1.68 mg/l, respectively, P for linearity = 0.003). Psychological distress was also associated with high relative cardiovascular risk (hsCRP >3.00 mg/l). After adjusting for gender, age, BMI, smoking, use of alcohol and leisure time physical activity, odds ratios for hsCRP >3.00 mg/l in the groups that had medium and high psychological distress were 1.32 (95% CI: 0.81-2.16) and 1.79 (95% CI: 1.05-3.04), respectively, compared with the low distress group (P for linearity 0.032). Psychological distress was associated with elevated hsCRP levels representing high relative cardiovascular risk. This association remained after adjusting for health behaviours and pathophysiological factors, supporting a direct, physiological link between psychological distress and inflammation. CRP could be an important pathophysiological mechanism through which psychological factors are associated with cardiovascular disease.

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    • "Those who are objectively stressed, such as caretakers of those with chronic conditions, have higher resting heart rates, blood pressure, and greater incidence of metabolic syndrome (Vitaliano et al., 2002). Individuals reporting higher levels of stressful life events have higher scores on risk factors for CVD, such as smoking (Ansell et al., 2012), systemic inflammation (Puustinen et al., 2011) and obesity (Sinha and Jastreboff, 2013). They are nearly twice as likely to start using anti-hypertensive medication over time compared to less stressed individuals (Rod et al., 2009). "

    Frontiers in Physiology 11/2013; 4:346. DOI:10.3389/fphys.2013.00346 · 3.53 Impact Factor
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    European Archives of Psychiatry and Clinical Neuroscience 06/2011; 261(4):311-2. DOI:10.1007/s00406-011-0221-7 · 3.53 Impact Factor
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    ABSTRACT: 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. 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. 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. 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.
    Scandinavian Journal of Public Health 08/2011; 39(6):577-81. DOI:10.1177/1403494811414244 · 1.83 Impact Factor
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