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Cited by 120Health disparities and outcomesCardiac Health and Mental HealthEmployment and Welfare Studies

The effects of psychological distress and its interaction with socioeconomic position on risk of developing four chronic diseases

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McLachlan, Kyle J.J., Gale, Catharine R.·2018·Journal of Psychosomatic Research
DOI 10.1016/j.jpsychores.2018.04.004PMC PMC5959313
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Abstract

OBJECTIVE: To examine the relationship between psychological distress and risk of developing arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes across the range of distress severity, investigate the mediating roles of health behaviours and explore whether the associations vary with socioeconomic position. METHODS: Participants were 16,485 adults from the UK Household Longitudinal Study We examined prospective relationships between psychological distress at baseline (measured using the 12-item General Health Questionnaire) and incidence of arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes (measured using self-report) over 3 years using logistic regression. We then examined the mediating effects of health behaviours and investigated whether the associations varied with socioeconomic position. RESULTS: Distress significantly increased risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern after controlling for age, sex, socioeconomic position, neighbourhood cohesion, marital status, BMI and baseline disease. High levels of distress (GHQ ≥ 7) increased risk of arthritis (OR 2.22; 1.58-2.13), cardiovascular disease (OR 3.06; 1.89-4.98) and chronic obstructive pulmonary disease (OR 3.25; 1.47-7.18). These associations were partially mediated by smoking status but remained significant after controlling for smoking status, diet and exercise. Distress significantly predicted incident diabetes in manual socioeconomic groups only. Effect sizes did not vary with socioeconomic position for arthritis, cardiovascular disease and chronic obstructive pulmonary disease. CONCLUSION: Psychological distress increases risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern, even at low and moderate distress levels. Future research should investigate the mediating role of inflammatory biomarkers.

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  • Extreme prolonged psychological distress is linked to increased drug and alcohol coping, increased cardiovascular illness risk, and higher suicide rates.

    “extreme prolonged psychological distress has been linked to an increased tendency to turn to drugs and alcohol as a coping mechanism, an increased risk of cardiovascular illness, and higher rates of suicide”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as McLachlan & Gale, 2018

    The Results and Discussion report that greater psychological distress was associated with increased cardiovascular disease risk in UK adults over three years. The Discussion mentions smoking as a possible coping response, but our copy does not support the claim about turning to drugs and alcohol or higher suicide rates; it also does not establish that distress was prolonged. (LLM, conf=0.90)

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References 71 · Cited by 120

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Authors
McLachlan, K. J. J., & Gale, C. R.
Affiliations
University of Edinburgh (GB)
Venue
Journal of Psychosomatic Research
Publisher
Elsevier BV
Published
2018-06
Volume
109
Pages
79-85
ISSN
0022-3999 (ISSN-L)
DOI
10.1016/j.jpsychores.2018.04.004
PMC
PMC5959313
OpenAlex
W2797787314
Cited by
120
References
71
Citations by year
2026: 12 · 2025: 12 · 2024: 23 · 2023: 18 · 2022: 20 · 2021: 18 · 2020: 6 · 2019: 10 · 2018: 1
FWCI
9.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Psychosomatic Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
Funders
MRC (MR/K026992/1)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
Keywords
psychological distress, socioeconomic position, arthritis, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, chronic disease incidence, health behavior, smoking, mediation, dose-response relationship, blue-collar workers
MeSH terms
Chronic Disease, Female, Humans, Longitudinal Studies, Male, Middle Aged, Risk Factors, Socioeconomic Factors, Stress, Psychological, Incidence

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