Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 68
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Byrne, D. Buttrey, S. Carberry, C. Lydon, S. and O’Connor, P. 2016. Is there a risk profile for the vulnerable junior doctor?. Irish Journal of Medical Science (1971 -), Vol. 185, Issue. 3, p. 603.

    Nielsen, Marie Germund Ørnbøl, Eva Vestergaard, Mogens Bech, Per Larsen, Finn Breinholt Lasgaard, Mathias and Christensen, Kaj Sparle 2016. The construct validity of the Perceived Stress Scale. Journal of Psychosomatic Research, Vol. 84, p. 22.

    Borowiecki, Karol Jan and Kavetsos, Georgios 2015. In fatal pursuit of immortal fame: Peer competition and early mortality of music composers. Social Science & Medicine, Vol. 134, p. 30.

    Fleury, Marie-Josée Bamvita, Jean-Marie Grenier, Guy and Caron, Jean 2015. Help Received for Perceived Needs Related to Mental Health in a Montreal (Canada) Epidemiological Catchment Area. International Journal of Environmental Research and Public Health, Vol. 12, Issue. 10, p. 13016.

    Marko, Dritana Linder, Stephen H. Tullar, Jessica M. Reynolds, Thomas F. and Estes, Larissa J. 2015. Predictors of Serious Psychological Distress in an Urban Population. Community Mental Health Journal, Vol. 51, Issue. 6, p. 708.

    André, Malin Billstedt, Eva Bengtsson, Calle Hällström, Tore Lissner, Lauren Skoog, Ingmar Sundh, Valter Waern, Margda and Björkelund, Cecilia 2014. Personality in women and associations with mortality: a 40-year follow-up in the Population Study of Women in Gothenburg. BMC Women's Health, Vol. 14, Issue. 1,

    Benabarre, Sergio Olivera, Javier Lorente, Teófilo Rodriguez, Mariano Barros-Loscertales, Alfonso Pelegrín, Carmelo Claver, Paula Galindo, Izarbe Labarta, María and Rodriguez, Jara 2014. Psychiatric symptoms are not an independent mortality risk factor in community-living elderly people. International Psychogeriatrics, Vol. 26, Issue. 06, p. 911.

    Friedman, Howard S. and Kern, Margaret L. 2014. Personality, Well-Being, and Health*. Annual Review of Psychology, Vol. 65, Issue. 1, p. 719.

    Ruf, Esther Baumert, Jens Meisinger, Christa Döring, Angela and Ladwig, Karl-Heinz 2014. Are psychosocial stressors associated with the relationship of alcohol consumption and all-cause mortality?. BMC Public Health, Vol. 14, Issue. 1,

    Steel, Jennifer L. Geller, David A. Robinson, Tiana L. Savkova, Alexandra Y. Brower, Deborah S. Marsh, J. Wallis and Tsung, Allan 2014. Health-related quality of life as a prognostic factor in patients with advanced cancer. Cancer, Vol. 120, Issue. 23, p. 3717.

    Kurina, Lianne M. McClintock, Martha K. Chen, Jen-Hao Waite, Linda J. Thisted, Ronald A. and Lauderdale, Diane S. 2013. Sleep duration and all-cause mortality: a critical review of measurement and associations. Annals of Epidemiology, Vol. 23, Issue. 6, p. 361.

    Lam, E. Kvaavik, E. Hamer, M. and Batty, G.D. 2013. Association of secondhand smoke exposure with mental health in men and women: Cross-sectional and prospective analyses using the UK Health and Lifestyle Survey. European Psychiatry, Vol. 28, Issue. 5, p. 276.

    Nam, Sanggon 2013. The Effects of Religious Attendance and Obesity on Health by Race/Ethnicity. Osong Public Health and Research Perspectives, Vol. 4, Issue. 2, p. 81.

    Stone, J. Evandrou, M. and Falkingham, J. 2013. The transition to living alone and psychological distress in later life. Age and Ageing, Vol. 42, Issue. 3, p. 366.

    Hagger-Johnson, Gareth Roberts, Beverly Boniface, David Sabia, Séverine Batty, G. David Elbaz, Alexis Singh-Manoux, Archana and Deary, Ian J. 2012. Neuroticism and Cardiovascular Disease Mortality. Psychosomatic Medicine, Vol. 74, Issue. 6, p. 596.

    Huppert, Felicia A. 2012. Positive Psychology in Practice.

    Leung, J. Gartner, C. Hall, W. Lucke, J. and Dobson, A. 2012. A longitudinal study of the bi-directional relationship between tobacco smoking and psychological distress in a community sample of young Australian women. Psychological Medicine, Vol. 42, Issue. 06, p. 1273.

    Lin, Min-Ting Burgess, James F. and Carey, Kathleen 2012. The association between serious psychological distress and emergency department utilization among young adults in the USA. Social Psychiatry and Psychiatric Epidemiology, Vol. 47, Issue. 6, p. 939.

    Maheswaran, Hendramoorthy Weich, Scott Powell, John and Stewart-Brown, Sarah 2012. Evaluating the responsiveness of the Warwick Edinburgh Mental Well-Being Scale (WEMWBS): Group and individual level analysis. Health and Quality of Life Outcomes, Vol. 10, Issue. 1, p. 156.

    Schnittger, Rebecca I.B. Walsh, Cathal D. Casey, Anne-Marie Wherton, Joseph P. McHugh, Joanna E. and Lawlor, Brian A. 2012. Psychological distress as a key component of psychosocial functioning in community-dwelling older people. Aging & Mental Health, Vol. 16, Issue. 2, p. 199.


Symptoms of psychological distress predict 7-year mortality

  • Felicia A. Huppert (a1) and Joyce E. Whittington (a1)
  • DOI:
  • Published online: 01 July 2009

As part of the Health and Lifestyle Survey (HALS), 6096 adults from a representative sample of community residents completed a standardized questionnaire which elicited psychiatric symptoms – the General Health Questionnaire (GHQ-30) of Goldberg (1972). Their survival status at 7 years was determined, and 474 had died. Respondents whose GHQ score was above the conventional threshold (4/5), used when screening for psychiatric disorder, were 60% more likely to die over the 7-year interval than respondents whose GHQ score was below threshold (risk ratio 1·64 for men and 1·58 for women). The differences were statistically significant for both sexes when the effects of age, physical disorder, social class and smoking behaviour were taken into account. Personality traits (neuroticism, extraversion) were not related to mortality, neither was self-reported difficulty in sleeping. However, a low subjective rating of one's general health was associated with increased mortality. We explored a range of cut-points and found reliable effects for both sexes at all cut-points from 3/4 to 6/7. Possible differences related to natural versus unnatural causes of death were explored and found not to explain the results. The findings from this general population study confirm that it is not only psychiatric disorders, but also psychiatric symptoms, which are associated with subsequent mortality, and thereby reinforce the importance of appropriate intervention to alleviate these symptoms.

Corresponding author
1Address for correspondence: Dr Felicia A. Huppert, University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ.
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S. J. Almada , A. B. Zonderman , R. B. Shekelle , A. R. Dyer , M. L. Daviglus , P. T. Costa & J. Stamler (1991). Neuroticism and cynicism and risk of death in middle-aged men: the Western Electric Study. Psychosomatic Medicine 53, 165175.

R. Anda , D. Williamson , D. Jones , C. Macera , E. Eaker , A. Glassman & J. Marks (1993). Depressed affect, hopelessness, and the risk of ischemic heart disease in a cohort of U.S. adults. Epidemiology 4, 285294.

D. W. Black , G. Winokur , E. Mohandoss , R. F. Woolson & A. Nasrallah (1989). Does treatment influence mortality in depressives? A follow-up of 1076 patients with major affective disorders. Annals of Clinical Psychiatry 1, 165173.

D. L. Bliwise , L. Friedman & J. A. Yesavage (1993). Depression as a confounding variable in the estimation of habitual sleep time. Journal of Clinical Psychology 49, 471477.

F. Casadebaig & N. Quemada (1989). Mortality in psychiatric inpatients. Acta Psychiatrica Scandinavica 79, 257264.

J. G. Chipperfield (1993). Incongruence between health perceptions and health problems. Journal of Aging and Health 5, 475496.

K. Enzell (1984). Mortality among persons with depressive symptoms and among responders and non-responders in a health check-up. Acta Psychiatrica Scandinavica 69, 89102.

J. S. House , K. R. Landis & D. Umberson (1988). Social relationships and health. Science 241, 540545.

C. Jagger & C. J. Sutton (1991). Death after marital bereavement – Is the risk increased? Statistics in Medicine 10, 395404.

J. Kaprio , M. Koskenvuo & H. Rita (1987). Mortality after bereavement: a prospective study of 95647 widowed persons. American Journal of Public Health 77, 283287.

T. A. Kerr , K. Schapira , M. Roth & R. F. Garside (1970). The relationship between the Maudsley Personality Inventory and the course of affective disorders. British Journal of Psychiatry 116, 1119.

D. F. Kripke , R. N. Simons , L. Garfinkel & E. C. Hammond (1979). Short and long sleep and sleeping pills: is increased mortality associated? Archives of General Psychiatry 36, 103116.

J. M. Murphy , R. R. Monson , D. C. Olivier , A. M. Sobol & A. H. Leighton (1987). Affective disorders and mortality. Archives of General Psychiatry 44, 473480.

A. PaganiniHill & G. Hsu (1994). Smoking and mortality among residents of a California retirement community. American Journal of Public Health 84, 992995.

B. Rorsman , O. Hagnell & J. Lanke (1982). Mortality in the Lundby study. Neuropsychobiology 8, 188197.

E. Singer , R. Garfinkel , S. M. Cohen & L. Srole (1976). Mortality and mental health: evidence from the Midtown Manhattan restudy. Social Science and Medicine 10, 517525.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *