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Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly study
Psychological distress is common after stroke, but little is known about its etiologic importance, although the general public often ascribes stroke to the experience of stress. Therefore, we examined whether psychological distress leads to an increased risk of ischemic stroke and transient ischemic...
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Published in: | Stroke (1970) 2002, Vol.33 (1), p.7-12 |
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container_title | Stroke (1970) |
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description | Psychological distress is common after stroke, but little is known about its etiologic importance, although the general public often ascribes stroke to the experience of stress. Therefore, we examined whether psychological distress leads to an increased risk of ischemic stroke and transient ischemic attack (TIA).
The association between the 30-item General Health Questionnaire (GHQ), a measure of psychological distress, and the incidence of nonfatal and fatal ischemic stroke and TIA was measured by Cox regression modeling in a prospective observational study of 2201 men aged 45 to 59 years in phase II of the Caerphilly cohort. Hazard ratios comparing those with high (> or = 5) and normal GHQ scores were calculated with adjustment for age and other covariates.
Twenty-two percent of men suffered from psychological distress, indicated by a score of > or =5 on the GHQ. There were 130 incident strokes recorded, of which 17 were fatal and 113 nonfatal. The relative risk of incident ischemic stroke was 1.45 (95% CI, 0.98 to 2.14) for those who showed symptoms of psychological distress compared with those who did not. For fatal stroke the relative risk was 3.36 (95% CI, 1.29 to 8.71) and for nonfatal stroke 1.25 (95% CI, 0.82 to 1.92). The relative risk of TIA for the distressed group was 0.63 (95% CI, 0.26 to 1.53). The results were unchanged after adjustment for body mass index, systolic blood pressure, smoking, heavy drinking, social class, and marital status. However, additionally controlling for previously diagnosed ischemic heart disease, diabetes, respiratory disease, and retirement due to ill health attenuated the relative risks, but not markedly. For fatal strokes the relative risk decreased to 2.56 (95% CI, 0.97 to 6.75) when all confounding variables were included in the model. There was a graded association between degree of psychological distress and risk of fatal ischemic stroke.
Psychological distress is a predictor of fatal ischemic stroke but not of nonfatal ischemic stroke or TIA. Further work examining the mechanisms of this association is required. |
doi_str_mv | 10.1161/hs0102.100529 |
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The association between the 30-item General Health Questionnaire (GHQ), a measure of psychological distress, and the incidence of nonfatal and fatal ischemic stroke and TIA was measured by Cox regression modeling in a prospective observational study of 2201 men aged 45 to 59 years in phase II of the Caerphilly cohort. Hazard ratios comparing those with high (> or = 5) and normal GHQ scores were calculated with adjustment for age and other covariates.
Twenty-two percent of men suffered from psychological distress, indicated by a score of > or =5 on the GHQ. There were 130 incident strokes recorded, of which 17 were fatal and 113 nonfatal. The relative risk of incident ischemic stroke was 1.45 (95% CI, 0.98 to 2.14) for those who showed symptoms of psychological distress compared with those who did not. For fatal stroke the relative risk was 3.36 (95% CI, 1.29 to 8.71) and for nonfatal stroke 1.25 (95% CI, 0.82 to 1.92). The relative risk of TIA for the distressed group was 0.63 (95% CI, 0.26 to 1.53). The results were unchanged after adjustment for body mass index, systolic blood pressure, smoking, heavy drinking, social class, and marital status. However, additionally controlling for previously diagnosed ischemic heart disease, diabetes, respiratory disease, and retirement due to ill health attenuated the relative risks, but not markedly. For fatal strokes the relative risk decreased to 2.56 (95% CI, 0.97 to 6.75) when all confounding variables were included in the model. There was a graded association between degree of psychological distress and risk of fatal ischemic stroke.
Psychological distress is a predictor of fatal ischemic stroke but not of nonfatal ischemic stroke or TIA. Further work examining the mechanisms of this association is required.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/hs0102.100529</identifier><identifier>PMID: 11779881</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Brain Ischemia - diagnosis ; Brain Ischemia - etiology ; Brain Ischemia - mortality ; Cohort Studies ; Depression - complications ; Follow-Up Studies ; Forecasting ; Humans ; Ischemic Attack, Transient - etiology ; Ischemic Attack, Transient - mortality ; Male ; Medical sciences ; Middle Aged ; Neurology ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Stress, Psychological - complications ; Stress, Psychological - diagnosis ; Stroke - diagnosis ; Stroke - etiology ; Stroke - mortality ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2002, Vol.33 (1), p.7-12</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Jan 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c335t-833cbd641c8e486072d214fe96df40300899de1001cdb74cc96281e115975aad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13449843$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11779881$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MAY, Margaret</creatorcontrib><creatorcontrib>MCCARRON, Peter</creatorcontrib><creatorcontrib>STANSFELD, Stephen</creatorcontrib><creatorcontrib>BEN-SHLOMO, Yoav</creatorcontrib><creatorcontrib>GALLACHER, John</creatorcontrib><creatorcontrib>YARNELL, John</creatorcontrib><creatorcontrib>SMITH, George Davey</creatorcontrib><creatorcontrib>ELWOOD, Peter</creatorcontrib><creatorcontrib>EBRAHIM, Shah</creatorcontrib><title>Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly study</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Psychological distress is common after stroke, but little is known about its etiologic importance, although the general public often ascribes stroke to the experience of stress. Therefore, we examined whether psychological distress leads to an increased risk of ischemic stroke and transient ischemic attack (TIA).
The association between the 30-item General Health Questionnaire (GHQ), a measure of psychological distress, and the incidence of nonfatal and fatal ischemic stroke and TIA was measured by Cox regression modeling in a prospective observational study of 2201 men aged 45 to 59 years in phase II of the Caerphilly cohort. Hazard ratios comparing those with high (> or = 5) and normal GHQ scores were calculated with adjustment for age and other covariates.
Twenty-two percent of men suffered from psychological distress, indicated by a score of > or =5 on the GHQ. There were 130 incident strokes recorded, of which 17 were fatal and 113 nonfatal. The relative risk of incident ischemic stroke was 1.45 (95% CI, 0.98 to 2.14) for those who showed symptoms of psychological distress compared with those who did not. For fatal stroke the relative risk was 3.36 (95% CI, 1.29 to 8.71) and for nonfatal stroke 1.25 (95% CI, 0.82 to 1.92). The relative risk of TIA for the distressed group was 0.63 (95% CI, 0.26 to 1.53). The results were unchanged after adjustment for body mass index, systolic blood pressure, smoking, heavy drinking, social class, and marital status. However, additionally controlling for previously diagnosed ischemic heart disease, diabetes, respiratory disease, and retirement due to ill health attenuated the relative risks, but not markedly. For fatal strokes the relative risk decreased to 2.56 (95% CI, 0.97 to 6.75) when all confounding variables were included in the model. There was a graded association between degree of psychological distress and risk of fatal ischemic stroke.
Psychological distress is a predictor of fatal ischemic stroke but not of nonfatal ischemic stroke or TIA. Further work examining the mechanisms of this association is required.</description><subject>Biological and medical sciences</subject><subject>Brain Ischemia - diagnosis</subject><subject>Brain Ischemia - etiology</subject><subject>Brain Ischemia - mortality</subject><subject>Cohort Studies</subject><subject>Depression - complications</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Humans</subject><subject>Ischemic Attack, Transient - etiology</subject><subject>Ischemic Attack, Transient - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Stress, Psychological - complications</subject><subject>Stress, Psychological - diagnosis</subject><subject>Stroke - diagnosis</subject><subject>Stroke - etiology</subject><subject>Stroke - mortality</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNpdkc2LFDEQxYMo7rh69CpB0FuvqSTdnZxExk9Y8LKem0xSbWenpzOm0of5743MwICngqpfFa_eY-w1iDuADj5MJEDIOxCilfYJ20ArdaM7aZ6yjRDKNlJbe8NeED0KIaQy7XN2A9D31hjYMPqckPiRTn5Kc_odvZt5iFQyUm1nDNEXXibkOdKep5FH8hMeoueVSXvkbgm8ZLdQxKVcp64U5_cf-UNd3TrMxynO86kureH0kj0b3Uz46lJv2a-vXx6235v7n99-bD_dN16ptjRGKb8LnQZvUJtO9DJI0CPaLoxaKCGMtQHr4-DDrtfe2_o1IEBr-9a5oG7Z-_PdY05_VqQyHKo-nGe3YFpp6EF1bQeqgm__Ax_TmpeqbQDbG9lWKRVqzpDPiSjjOBxzPLh8GkAM_6IYzlEM5ygq_-ZydN0dMFzpi_cVeHcBHFXbx2qij3TllNbWaKX-AqJvkWM</recordid><startdate>2002</startdate><enddate>2002</enddate><creator>MAY, Margaret</creator><creator>MCCARRON, Peter</creator><creator>STANSFELD, Stephen</creator><creator>BEN-SHLOMO, Yoav</creator><creator>GALLACHER, John</creator><creator>YARNELL, John</creator><creator>SMITH, George Davey</creator><creator>ELWOOD, Peter</creator><creator>EBRAHIM, Shah</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>2002</creationdate><title>Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly study</title><author>MAY, Margaret ; MCCARRON, Peter ; STANSFELD, Stephen ; BEN-SHLOMO, Yoav ; GALLACHER, John ; YARNELL, John ; SMITH, George Davey ; ELWOOD, Peter ; EBRAHIM, Shah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-833cbd641c8e486072d214fe96df40300899de1001cdb74cc96281e115975aad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Biological and medical sciences</topic><topic>Brain Ischemia - diagnosis</topic><topic>Brain Ischemia - etiology</topic><topic>Brain Ischemia - mortality</topic><topic>Cohort Studies</topic><topic>Depression - complications</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Humans</topic><topic>Ischemic Attack, Transient - etiology</topic><topic>Ischemic Attack, Transient - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Stress, Psychological - complications</topic><topic>Stress, Psychological - diagnosis</topic><topic>Stroke - diagnosis</topic><topic>Stroke - etiology</topic><topic>Stroke - mortality</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MAY, Margaret</creatorcontrib><creatorcontrib>MCCARRON, Peter</creatorcontrib><creatorcontrib>STANSFELD, Stephen</creatorcontrib><creatorcontrib>BEN-SHLOMO, Yoav</creatorcontrib><creatorcontrib>GALLACHER, John</creatorcontrib><creatorcontrib>YARNELL, John</creatorcontrib><creatorcontrib>SMITH, George Davey</creatorcontrib><creatorcontrib>ELWOOD, Peter</creatorcontrib><creatorcontrib>EBRAHIM, Shah</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MAY, Margaret</au><au>MCCARRON, Peter</au><au>STANSFELD, Stephen</au><au>BEN-SHLOMO, Yoav</au><au>GALLACHER, John</au><au>YARNELL, John</au><au>SMITH, George Davey</au><au>ELWOOD, Peter</au><au>EBRAHIM, Shah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly study</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2002</date><risdate>2002</risdate><volume>33</volume><issue>1</issue><spage>7</spage><epage>12</epage><pages>7-12</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Psychological distress is common after stroke, but little is known about its etiologic importance, although the general public often ascribes stroke to the experience of stress. Therefore, we examined whether psychological distress leads to an increased risk of ischemic stroke and transient ischemic attack (TIA).
The association between the 30-item General Health Questionnaire (GHQ), a measure of psychological distress, and the incidence of nonfatal and fatal ischemic stroke and TIA was measured by Cox regression modeling in a prospective observational study of 2201 men aged 45 to 59 years in phase II of the Caerphilly cohort. Hazard ratios comparing those with high (> or = 5) and normal GHQ scores were calculated with adjustment for age and other covariates.
Twenty-two percent of men suffered from psychological distress, indicated by a score of > or =5 on the GHQ. There were 130 incident strokes recorded, of which 17 were fatal and 113 nonfatal. The relative risk of incident ischemic stroke was 1.45 (95% CI, 0.98 to 2.14) for those who showed symptoms of psychological distress compared with those who did not. For fatal stroke the relative risk was 3.36 (95% CI, 1.29 to 8.71) and for nonfatal stroke 1.25 (95% CI, 0.82 to 1.92). The relative risk of TIA for the distressed group was 0.63 (95% CI, 0.26 to 1.53). The results were unchanged after adjustment for body mass index, systolic blood pressure, smoking, heavy drinking, social class, and marital status. However, additionally controlling for previously diagnosed ischemic heart disease, diabetes, respiratory disease, and retirement due to ill health attenuated the relative risks, but not markedly. For fatal strokes the relative risk decreased to 2.56 (95% CI, 0.97 to 6.75) when all confounding variables were included in the model. There was a graded association between degree of psychological distress and risk of fatal ischemic stroke.
Psychological distress is a predictor of fatal ischemic stroke but not of nonfatal ischemic stroke or TIA. Further work examining the mechanisms of this association is required.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11779881</pmid><doi>10.1161/hs0102.100529</doi><tpages>6</tpages></addata></record> |
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subjects | Biological and medical sciences Brain Ischemia - diagnosis Brain Ischemia - etiology Brain Ischemia - mortality Cohort Studies Depression - complications Follow-Up Studies Forecasting Humans Ischemic Attack, Transient - etiology Ischemic Attack, Transient - mortality Male Medical sciences Middle Aged Neurology Proportional Hazards Models Prospective Studies Risk Factors Stress, Psychological - complications Stress, Psychological - diagnosis Stroke - diagnosis Stroke - etiology Stroke - mortality Vascular diseases and vascular malformations of the nervous system |
title | Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly study |
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