Chronic Disease Development Related to Monthly Mental Distress Days

Chronic diseases have a significant positive relationship with mental distress, with significant age and gender interactions. These study results were published in Journal of Psychosomatic Research.

Researchers from Guangdong Pharmaceutical University in China sourced data from the Behavioral Risk Factor Surveillance System (BRFSS), a random telephone number survey study conducted since 1984 in the United States. Data from survey waves from 2013 to 2017 were evaluated for risk for 10 chronic diseases on the basis of mental health status.

Among the 1,932,421 participants, 79.0% reported 4 or fewer mental distress days per month, 9.3% reported 5 to 10, 3.5% reported 11 to 16, 1.9% reported 17 to 22, and 6.4% reported 23 or more mental distress days per month, respectively. Nearly half of the participants were women and employed. Most participants were aged 18 to 44 years, White, had more than a high school diploma, and were daily smokers.

The highest average number of mental distress days per month was observed for individuals with chronic obstructive pulmonary disease (COPD; 7.65 days), followed by stroke (6.65 days), kidney disease (6.31 days), asthma (6.03 days), coronary heart disease (CHD; 5.46 days), arthritis (5.32 days), diabetes (4.81 days), nonskin cancers (4.57 days), obesity (4.47 days), and skin cancers (3.13 days).

In a subgroup analysis, women reported more mental distress days in general. Women who reported 17 to 22 and 23 or more monthly mental distress days were associated with having increased risk for asthma, CHD, COPD, and diabetes. The younger individuals (aged 18 to 44 years) who reported 23 or more distress days per month had the highest risk for chronic diseases compared with other participants.

After adjusting for age, gender, education level, ethnicity, employment, smoking status, and survey year, there was a dose-dependent relationship between mental distress days and all diseases (all P <.001). For example, compared with individuals who had 4 or fewer mental distress days per month, risk for COPD increased among individuals with 5 to 10 (adjusted odds ratio [aOR], 1.76; 95% CI, 1.70-1.84), 11 to 16 (aOR, 2.13; 95% CI, 2.01-2.24), 17 to 22 (aOR, 2.49; 95% CI, 2.32-2.67), and 23 or more (aOR, 2.66; 95% CI, 2.56-2.76) distress days per month (all P <0.001), respectively.

The major limitation of this study was the reliance on self-reported mental distress days.

Study authors concluded, “Our study showed a positive dose-response relationship between mental distress and the risk of chronic diseases, specifically obesity, diabetes, asthma, COPD, arthritis, kidney disease, CHD, stroke, and other cancers. Significant sex and age differences in the association between mental distress and the risk of chronic diseases were observed. […] Further research is needed to better understand the sex and age differences in the association between mental distress and the risk of chronic diseases.”