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The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death
Abstract Objective: To determine whether cardiac mortality is abnormally high on days considered unlucky: Chinese and Japanese people consider the number 4 unlucky, white Americans do not. Design: Examination of cardiac and non-cardiac mortality on and around the fourth of each month in Chinese and...
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Published in: | BMJ 2001-12, Vol.323 (7327), p.1443-1446 |
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description | Abstract Objective: To determine whether cardiac mortality is abnormally high on days considered unlucky: Chinese and Japanese people consider the number 4 unlucky, white Americans do not. Design: Examination of cardiac and non-cardiac mortality on and around the fourth of each month in Chinese and Japanese subjects and white controls. Setting: United States. Subjects: All Chinese and Japanese (n=209 908) and white (n=47 328 762) Americans whose computerised death certificates were recorded between the beginning of January 1973 and the end of December 1998. Main outcome measures: Ratio of observed to expected numbers of deaths on the fourth day of the month (expected number was estimated from mortality on other days of the month). Results: Cardiac mortality in Chinese and Japanese people peaked on the fourth of the month. The peak was particularly large for deaths from chronic heart disease (ratio of observed to expected deaths = 1.13, 95% confidence interval 1.06 to 1.21) and still larger for deaths from chronic heart disease in California (1.27, 1.15 to 1.39). Within this group, inpatients showed a particularly large peak on the fourth day(1.45, 1.19 to 1.81). The peak was not followed by a compensatory drop in number of deaths. White controls, matched on age, sex, marital status, hospital status, location, and cause of death, showed no similar peak in cardiac mortality. Conclusions: Our findings of excess cardiac mortality on “unlucky” days are consistent with the hypothesis that cardiac mortality increases on psychologically stressful occasions. The results are inconsistent with nine other possible explanations for the findings—for example, the fourth day peak does not seem to occur because of changes in the patient's diet, alcohol intake, exercise, or drug regimens. What is already known on this topic Laboratory studies show that cardiovascular changes occur after mild psychological stress, but it is unclear whether fatal heart attacks increase after psychological stress Previous non-laboratory studies were unable to control for physical and medical changes associated with most stressful occasions What this study adds Unlike white people, Chinese and Japanese associate the number 4 with death. Cardiac mortality in Chinese and Japanese Americans peaks on the fourth day of the month, even though this date is not consistently associated with changes in the physical or medical environment In The Hound of the Baskervilles, Charles Baskerville died from a h |
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Design: Examination of cardiac and non-cardiac mortality on and around the fourth of each month in Chinese and Japanese subjects and white controls. Setting: United States. Subjects: All Chinese and Japanese (n=209 908) and white (n=47 328 762) Americans whose computerised death certificates were recorded between the beginning of January 1973 and the end of December 1998. Main outcome measures: Ratio of observed to expected numbers of deaths on the fourth day of the month (expected number was estimated from mortality on other days of the month). Results: Cardiac mortality in Chinese and Japanese people peaked on the fourth of the month. The peak was particularly large for deaths from chronic heart disease (ratio of observed to expected deaths = 1.13, 95% confidence interval 1.06 to 1.21) and still larger for deaths from chronic heart disease in California (1.27, 1.15 to 1.39). Within this group, inpatients showed a particularly large peak on the fourth day(1.45, 1.19 to 1.81). The peak was not followed by a compensatory drop in number of deaths. White controls, matched on age, sex, marital status, hospital status, location, and cause of death, showed no similar peak in cardiac mortality. Conclusions: Our findings of excess cardiac mortality on “unlucky” days are consistent with the hypothesis that cardiac mortality increases on psychologically stressful occasions. The results are inconsistent with nine other possible explanations for the findings—for example, the fourth day peak does not seem to occur because of changes in the patient's diet, alcohol intake, exercise, or drug regimens. What is already known on this topic Laboratory studies show that cardiovascular changes occur after mild psychological stress, but it is unclear whether fatal heart attacks increase after psychological stress Previous non-laboratory studies were unable to control for physical and medical changes associated with most stressful occasions What this study adds Unlike white people, Chinese and Japanese associate the number 4 with death. Cardiac mortality in Chinese and Japanese Americans peaks on the fourth day of the month, even though this date is not consistently associated with changes in the physical or medical environment In The Hound of the Baskervilles, Charles Baskerville died from a heart attack induced by stress; this “Baskerville effect” seems to exist in fact as well as in fiction</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>ISSN: 0959-535X</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.323.7327.1443</identifier><identifier>PMID: 11751347</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Adult and adolescent clinical studies ; Asian people ; Beyond Science ; Biological and medical sciences ; Calendars ; China - ethnology ; Chinese American people ; College students ; Comparative studies ; Death ; Death certificates ; Death, Sudden, Cardiac - ethnology ; Death, Sudden, Cardiac - etiology ; Heart diseases ; Humans ; Intuition ; Japan - ethnology ; Japanese American people ; Medical sciences ; Medicine in Literature ; Miscellaneous ; Mortality ; Myocardial infarction ; Natural experiments ; Psychological stress ; Psychology ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Stress ; Stress, Psychological - complications ; Stress, Psychological - ethnology ; Superstition ; Superstitions ; Timing ; United States - epidemiology ; USA ; White people</subject><ispartof>BMJ, 2001-12, Vol.323 (7327), p.1443-1446</ispartof><rights>2001 BMJ Publishing Group Ltd.</rights><rights>Copyright 2001 BMJ</rights><rights>2002 INIST-CNRS</rights><rights>Copyright: 2001 (c) 2001 BMJ Publishing Group Ltd.</rights><rights>Copyright BMJ Publishing Group Dec 22-Dec 29, 2001</rights><rights>Copyright © 2001, BMJ 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b606t-8cf6c4bf3f39e312390e7b409c1db069879ff0b64d64819675098b5225afbe343</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/323/7327/1443.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bmj.com/content/323/7327/1443.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>112,113,230,314,776,780,881,3180,27903,27904,30978,30979,58216,58449,77340,77341</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13383828$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11751347$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Phillips, David P</creatorcontrib><creatorcontrib>Liu, George C</creatorcontrib><creatorcontrib>Kwok, Kennon</creatorcontrib><creatorcontrib>Jarvinen, Jason R</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Abramson, Ian S</creatorcontrib><title>The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Abstract Objective: To determine whether cardiac mortality is abnormally high on days considered unlucky: Chinese and Japanese people consider the number 4 unlucky, white Americans do not. Design: Examination of cardiac and non-cardiac mortality on and around the fourth of each month in Chinese and Japanese subjects and white controls. Setting: United States. Subjects: All Chinese and Japanese (n=209 908) and white (n=47 328 762) Americans whose computerised death certificates were recorded between the beginning of January 1973 and the end of December 1998. Main outcome measures: Ratio of observed to expected numbers of deaths on the fourth day of the month (expected number was estimated from mortality on other days of the month). Results: Cardiac mortality in Chinese and Japanese people peaked on the fourth of the month. The peak was particularly large for deaths from chronic heart disease (ratio of observed to expected deaths = 1.13, 95% confidence interval 1.06 to 1.21) and still larger for deaths from chronic heart disease in California (1.27, 1.15 to 1.39). Within this group, inpatients showed a particularly large peak on the fourth day(1.45, 1.19 to 1.81). The peak was not followed by a compensatory drop in number of deaths. White controls, matched on age, sex, marital status, hospital status, location, and cause of death, showed no similar peak in cardiac mortality. Conclusions: Our findings of excess cardiac mortality on “unlucky” days are consistent with the hypothesis that cardiac mortality increases on psychologically stressful occasions. The results are inconsistent with nine other possible explanations for the findings—for example, the fourth day peak does not seem to occur because of changes in the patient's diet, alcohol intake, exercise, or drug regimens. What is already known on this topic Laboratory studies show that cardiovascular changes occur after mild psychological stress, but it is unclear whether fatal heart attacks increase after psychological stress Previous non-laboratory studies were unable to control for physical and medical changes associated with most stressful occasions What this study adds Unlike white people, Chinese and Japanese associate the number 4 with death. Cardiac mortality in Chinese and Japanese Americans peaks on the fourth day of the month, even though this date is not consistently associated with changes in the physical or medical environment In The Hound of the Baskervilles, Charles Baskerville died from a heart attack induced by stress; this “Baskerville effect” seems to exist in fact as well as in fiction</description><subject>Adult and adolescent clinical studies</subject><subject>Asian people</subject><subject>Beyond Science</subject><subject>Biological and medical sciences</subject><subject>Calendars</subject><subject>China - ethnology</subject><subject>Chinese American people</subject><subject>College students</subject><subject>Comparative studies</subject><subject>Death</subject><subject>Death certificates</subject><subject>Death, Sudden, Cardiac - ethnology</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Intuition</subject><subject>Japan - ethnology</subject><subject>Japanese American people</subject><subject>Medical sciences</subject><subject>Medicine in Literature</subject><subject>Miscellaneous</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Natural experiments</subject><subject>Psychological stress</subject><subject>Psychology</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Stress</subject><subject>Stress, Psychological - complications</subject><subject>Stress, Psychological - ethnology</subject><subject>Superstition</subject><subject>Superstitions</subject><subject>Timing</subject><subject>United States - epidemiology</subject><subject>USA</subject><subject>White people</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqF0s9v0zAUB_AIgdg09gdwAEUgOJHi33YQF6hgQ5qKBGMHLpbj2q271C62M23_Pc5adYCEdoqi93nRey_fqnoKwQRCzN5269UEIzzhGPEJJAQ_qA4hYaKhAuOH1SFoadsIiMVBdZzSCgCAMBcto4-rAwg5hZjwwyqfL019GgY_r4Otc3n5qNKliVeu702qjbVG53e1V3mIqq_N9cZEtzY-18HfcudtPxivzdi_STd6GfqwcLrglKNJ6Ra6tfOLUcyNyssn1SOr-mSOd8-j6sfnT-fT0-bs68mX6YezpmOA5UZoyzTpLLa4NRgi3ALDOwJaDecdYK3grbWgY2TOiIAt4xS0oqMIUWU7gwk-qt5vv7sZurWZ6zJ2WUJuygYq3signPy74t1SLsKVZBAQWtpf79pj-DWYlOXaJW36XnkThiR5OWgZFN4LKecIMtQW-OIfuApD9OUGEgECMKWMF_TyfwhyLgArBhUFt0rHkFI0dr8WBHIMiCwBkQXKMSByDEjpef7nPe46dnEo4NUOqFT-oI3Ka5fuHMYCCySKe7Z1q5RD3NcRLfljcDxIs627lM31vq7ipSzDcypnF1P5_eJkNvsGf8pxsDdbP858_x6_AVwa6l8</recordid><startdate>20011222</startdate><enddate>20011222</enddate><creator>Phillips, David P</creator><creator>Liu, George C</creator><creator>Kwok, Kennon</creator><creator>Jarvinen, Jason R</creator><creator>Zhang, Wei</creator><creator>Abramson, Ian S</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><general>BMJ</general><scope>BSCLL</scope><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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20011222</creationdate><title>The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death</title><author>Phillips, David P ; Liu, George C ; Kwok, Kennon ; Jarvinen, Jason R ; Zhang, Wei ; Abramson, Ian S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b606t-8cf6c4bf3f39e312390e7b409c1db069879ff0b64d64819675098b5225afbe343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult and adolescent clinical studies</topic><topic>Asian people</topic><topic>Beyond Science</topic><topic>Biological and medical sciences</topic><topic>Calendars</topic><topic>China - ethnology</topic><topic>Chinese American people</topic><topic>College students</topic><topic>Comparative studies</topic><topic>Death</topic><topic>Death certificates</topic><topic>Death, Sudden, Cardiac - ethnology</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Intuition</topic><topic>Japan - ethnology</topic><topic>Japanese American people</topic><topic>Medical sciences</topic><topic>Medicine in Literature</topic><topic>Miscellaneous</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Natural experiments</topic><topic>Psychological stress</topic><topic>Psychology</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Stress</topic><topic>Stress, Psychological - complications</topic><topic>Stress, Psychological - ethnology</topic><topic>Superstition</topic><topic>Superstitions</topic><topic>Timing</topic><topic>United States - epidemiology</topic><topic>USA</topic><topic>White people</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Phillips, David P</creatorcontrib><creatorcontrib>Liu, George C</creatorcontrib><creatorcontrib>Kwok, Kennon</creatorcontrib><creatorcontrib>Jarvinen, Jason R</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Abramson, Ian S</creatorcontrib><collection>Istex</collection><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 Central (Corporate)</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>ProQuest research library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Phillips, David P</au><au>Liu, George C</au><au>Kwok, Kennon</au><au>Jarvinen, Jason R</au><au>Zhang, Wei</au><au>Abramson, Ian S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2001-12-22</date><risdate>2001</risdate><volume>323</volume><issue>7327</issue><spage>1443</spage><epage>1446</epage><pages>1443-1446</pages><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>Abstract Objective: To determine whether cardiac mortality is abnormally high on days considered unlucky: Chinese and Japanese people consider the number 4 unlucky, white Americans do not. Design: Examination of cardiac and non-cardiac mortality on and around the fourth of each month in Chinese and Japanese subjects and white controls. Setting: United States. Subjects: All Chinese and Japanese (n=209 908) and white (n=47 328 762) Americans whose computerised death certificates were recorded between the beginning of January 1973 and the end of December 1998. Main outcome measures: Ratio of observed to expected numbers of deaths on the fourth day of the month (expected number was estimated from mortality on other days of the month). Results: Cardiac mortality in Chinese and Japanese people peaked on the fourth of the month. The peak was particularly large for deaths from chronic heart disease (ratio of observed to expected deaths = 1.13, 95% confidence interval 1.06 to 1.21) and still larger for deaths from chronic heart disease in California (1.27, 1.15 to 1.39). Within this group, inpatients showed a particularly large peak on the fourth day(1.45, 1.19 to 1.81). The peak was not followed by a compensatory drop in number of deaths. White controls, matched on age, sex, marital status, hospital status, location, and cause of death, showed no similar peak in cardiac mortality. Conclusions: Our findings of excess cardiac mortality on “unlucky” days are consistent with the hypothesis that cardiac mortality increases on psychologically stressful occasions. The results are inconsistent with nine other possible explanations for the findings—for example, the fourth day peak does not seem to occur because of changes in the patient's diet, alcohol intake, exercise, or drug regimens. What is already known on this topic Laboratory studies show that cardiovascular changes occur after mild psychological stress, but it is unclear whether fatal heart attacks increase after psychological stress Previous non-laboratory studies were unable to control for physical and medical changes associated with most stressful occasions What this study adds Unlike white people, Chinese and Japanese associate the number 4 with death. Cardiac mortality in Chinese and Japanese Americans peaks on the fourth day of the month, even though this date is not consistently associated with changes in the physical or medical environment In The Hound of the Baskervilles, Charles Baskerville died from a heart attack induced by stress; this “Baskerville effect” seems to exist in fact as well as in fiction</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>11751347</pmid><doi>10.1136/bmj.323.7327.1443</doi><tpages>4</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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subjects | Adult and adolescent clinical studies Asian people Beyond Science Biological and medical sciences Calendars China - ethnology Chinese American people College students Comparative studies Death Death certificates Death, Sudden, Cardiac - ethnology Death, Sudden, Cardiac - etiology Heart diseases Humans Intuition Japan - ethnology Japanese American people Medical sciences Medicine in Literature Miscellaneous Mortality Myocardial infarction Natural experiments Psychological stress Psychology Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Stress Stress, Psychological - complications Stress, Psychological - ethnology Superstition Superstitions Timing United States - epidemiology USA White people |
title | The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death |
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