Hostility May Explain the Association between Depressive Mood and Mortality: Evidence from the French GAZEL Cohort StudyLemogne C.a–c · Nabi H.d · Zins M.d, f · Cordier S.g · Ducimetière P.e · Goldberg M.d · Consoli S.M.a, b
aAssistance Publique-Hôpitaux de Paris, Department of C-L Psychiatry, European Georges Pompidou Hospital, bParis Descartes University, and cCNRS USR 3246, Pitié-Salpêtrière Hospital, Paris; dINSERM U687, IFR69, and eINSERM U258, IFR69, Paul Brousse Hospital, Villejuif; fCETAF, RPPC Team, Saint-Mandé; gINSERM U625, Rennes 1 University, Rennes, France
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background: Depressive mood is associated with mortality. Because personality has been found to be associated with depression and mortality as well, we aimed to test whether depressive mood could predict mortality when adjusting for several measures of personality. Methods: 20,625 employees of the French national gas and electricity companies gave consent to enter in the GAZEL cohort in 1989. Questionnaires were mailed in 1993 to assess depressive mood, type A behavior pattern, hostility, and the six personality types proposed by Grossarth-Maticek and Eysenck. Vital status and date of death were obtained annually for all participants. The association between psychological variables and mortality was measured by the Relative Index of Inequality (RII) computed through Cox regression. Results: 14,356 members of the GAZEL cohort (10,916 men, mean age: 49 years; 3,965 women, mean age: 46 years) completed the depressive mood scale and at least one personality scale. During a mean follow-up of 14.8 years, 687 participants had died. Depressive mood predicted mortality, even after adjustment for age, sex, education level, body mass index, alcohol consumption, and smoking [RII (95% CI) = 1.56 (1.16–2.11)]. However, this association was dramatically reduced (RII reduction: 78.9%) after further adjustment for cognitive hostility (i.e. hostile thoughts) [RII (95% CI) = 1.12 (0.80–1.57)]. Cognitive hostility was the only personality measure remaining associated with mortality after adjustment for depressive mood [RII (95% CI) = 1.97 (1.39–2.77)]. Conclusions: Cognitive hostility may either confound or mediate the association between depressive mood and mortality.
© 2010 S. Karger AG, Basel
- Ustün TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ: Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004;184:386–392.
- Zheng D, Macera CA, Croft JB, Giles WH, Davis D, Scott WK: Major depression and all-cause mortality among white adults in the United States. Ann Epidemiol 1997;7:213–218.
- Everson SA, Roberts RE, Goldberg DE, Kaplan GA: Depressive symptoms and increased risk of stroke mortality over a 29-year period. Arch Intern Med 1998;158:1133–1138.
- Whooley MA, Browner WS: Association between depressive symptoms and mortality in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med 1998;158:2129–2135.
- Black SA, Markides KS: Depressive symptoms and mortality in older Mexican Americans. Ann Epidemiol 1999;9:45–52.
- Schulz R, Beach SR, Ives DG, Martire LM, Ariyo AA, Kop WJ: Association between depression and mortality in older adults: the Cardiovascular Health Study. Arch Intern Med 2000;160:1761–1768.
- Surtees PG, Wainwright NW, Luben RN, Wareham NJ, Bingham SA, Khaw KT: Depression and ischemic heart disease mortality: evidence from the EPIC-Norfolk United Kingdom prospective cohort study. Am J Psychiatry 2008;165:515–523.
- Roberts RE, Kaplan GA, Camacho TC: Psychological distress and mortality: evidence from the Alameda County Study. Soc Sci Med 1990;31:527–536.
- Coryell W, Turvey C, Leon A, Maser JD, Solomon D, Endicott J, Mueller T, Keller M: Persistence of depressive symptoms and cardiovascular death among patients with affective disorder. Psychosom Med 1999;61:755–761.
- Fredman L, Magaziner J, Hebel JR, Hawkes W, Zimmerman SI: Depressive symptoms and 6-year mortality among elderly community-dwelling women. Epidemiology 1999;10:54–59.
- Lane D, Carroll D, Ring C, Beevers DG, Lip GY: Mortality and quality of life 12 months after myocardial infarction: effects of depression and anxiety. Psychosom Med 2001;63:221–230.
- Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ: A longitudinal twin study of personality and major depression in women. Arch Gen Psychiatry 1993;50:853–862.
- Cloninger CR, Svrakic DM, Przybeck TR: Can personality assessment predict future depression? A twelve-month follow-up of 631 subjects. J Affect Disord 2006;92:35–44.
- Barefoot JC, Larsen S, von der Lieth L, Schroll M: Hostility, incidence of acute myocardial infarction, and mortality in a sample of older Danish men and women. Am J Epidemiol 1995;142:477–484.
- Everson SA, Kauhanen J, Kaplan GA: Hostility and increased risk of mortality and acute myocardial infarction: the mediating role of behavioral risk factors. Am J Epidemiol 1997;146:142–152.
- Boyle SH, Williams RB, Mark DB, Brummett BH, Siegler IC, Barefoot JC: Hostility, age, and mortality in a sample of cardiac patients. Am J Cardiol 2005;96:64–66.
- Olson MB, Krantz DS, Kelsey SF, Pepine CJ, Sopko G, Handberg E, Rogers WJ, Gierach GL, McClure CK, Merz CNB, for the WISE Study Group: Hostility scores are associated with increased risk of cardiovascular events in women undergoing coronary angiography: a report from the NHLBI-sponsored WISE study. Psychosom Med 2005;67:546–552.
- Nabi H, Kivimäki M, Zins M, Elovainio M, Consoli SM, Cordier S, Ducimetière P, Goldberg M, Singh-Manoux A: Does personality predict mortality? Results from the GAZEL French prospective cohort study. Int J Epidemiol 2008;37:386–396.
- Grossarth-Maticek R, Bastiaans J, Kanazir DT: Psychosocial factors as strong predictors of mortality from cancer, ischaemic heart disease and stroke: the Yugoslav prospective study. J Psychosom Res 1985;29:167–176.
- Nagano J, Sudo N, Kubo C, Kono S: Lung cancer, myocardial infarction, and the Grossarth-Maticek personality types: a case-control study in Fukuoka, Japan. J Epidemiol 2001;11:281–287.
- Nagano J, Ichinose Y, Asoh H: A prospective Japanese study of the association between personality and the progression of lung cancer. Intern Med 2006;45:57–63.
- Consoli SM, Cordier S, Ducimetière P: Validation of a personality questionnaire designed for defining subgroups at risk for ischemic cardiopathy or cancer in the Gazel cohort. Rev Epidemiol Sante Publique 1993;41:315–326.
- Goldberg M, Leclerc A, Bonenfant S, Chastang JF, Schmaus A, Kaniewski N, Zins M: Cohort profile: the GAZEL Cohort Study. Int J Epidemiol 2007;36:32–39.
- Grossarth-Maticek R, Eysenck HJ: Personality, stress and disease: description and validation of a new inventory. Psychol Rep 1990;66:355–373.
- Friedman M, Rosenman RH: Association of specific overt behavior pattern with blood and cardiovascular findings; blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. J Am Med Assoc 1959;169:1286–1296.
- Haynes SG, Feinleib M, Kannel WB: The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight-year incidence of coronary heart disease. Am J Epidemiol 1980;111:37–58.
- Myrtek M: Meta-analyses of prospective studies on coronary heart disease, type A personality, and hostility. Int J Cardiol 2001;79:245–251.
- Surtees PG, Wainwright NW, Luben R, Day NE, Khaw KT: Prospective cohort study of hostility and the risk of cardiovascular disease mortality. Int J Cardiol 2005;100:155–161.
Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977;1:385–401.
Fuhrer R, Rouillon F: The French version of the Center for Epidemiologic Studies-Depression Scale. Psychiatry Psychobiol 1989; 4:163–166.
- Bortner RW: A short rating scale as a potential measure of pattern A behavior. J Chronic Dis 1969;22:87–91.
The Belgian-French Pooling Project: assessment of type A behavior by the Bortner Scale and ischaemic heart disease. Eur Heart J 1984;5:440–446.
- Buss AH, Durkee A: An inventory for assessing different kinds of hostility. J Consult Psychol 1957;21:343–349.
- Suarez EC: The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics. Psychosom Med 1990;52:558–570.
- Sergeant JC, Firth D: Relative index of inequality: definition, estimation and inference. Biostatistics 2006;7:213–224.
- MacKinnon DP, Krull JL, Lockwood CM: Equivalence of the mediation, confounding and suppression effect. Prev Sci 2000;1:173–181.
- Yan LL, Liu K, Matthews KA, Daviglus ML, Ferguson TF, Kiefe CI: Psychosocial factors and risk of hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study. JAMA 2003;290:2138–2148.
- Ranjit N, Diez-Roux AV, Shea S, Cushman M, Seeman T, Jackson SA, Ni H: Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Arch Intern Med 2007;167:174–181.
- Roberts BW, DelVecchio WF: The rank-order consistency of personality traits from childhood to old age: a quantitative review of longitudinal studies. Psychol Bull 2000;126:3–25.
- Linden M, Baumann K, Rotter M, Schippan B: Posttraumatic embitterment disorder in comparison to other mental disorders. Psychother Psychosom 2008;77:50–56.
- Bech P: Fifty years with the Hamilton Scales for Anxiety and Depression: a tribute to Max Hamilton. Psychother Psychosom 2009;78:202–211.
- Baune BT, Caniato RN, Arolt V, Berger K: The effects of dysthymic disorder on health-related quality of life and disability days in persons with comorbid medical conditions in the general population. Psychother Psychosom 2009;78:161–166.
- Fava GA, Sonino N: The biopsychosocial model thirty years later. Psychother Psychosom 2008;77:1–2.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.