Perceived mental stress in women associated with psychosomatic symptoms, but not mortality: observations from the Population Study of Women in Gothenburg, Sweden

Abstract

Dominique Hange,1 Kirsten Mehlig,2 Lauren Lissner,2 Xinxin Guo,3 Calle Bengtsson,1,† Ingmar Skoog,3 Cecilia Björkelund1 1Department of Public Health and Community Medicine/Primary Health Care, 2Department of Public Health and Community Medicine/Public Health Epidemiology, 3Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden †Calle Bengtsson passed away on 23rd March 2013 Purpose: To investigate possible association between mental stress and psychosomatic symptoms, socioeconomic status, lifestyle, as well as incident mortality in a middle-aged female population followed over 37 years. Methods: A prospective observational study initiated in 1968–1969, including 1462 women aged 60, 54, 50, 46, and 38 years, with follow-ups in 1974–1975, 1980–1981, and 2000–2001, was performed. Measures included self-reported mental stress as well as psychosomatic symptoms and smoking, physical activity, total cholesterol, S-triglycerides, body mass index, waist–hip ratio, blood pressure, socioeconomic status and mortality. Results: Smoking, not being single, and not working outside home were strongly associated with reported mental stress at baseline. Women who reported high mental stress in 1968–1969 were more likely to report presence of abdominal symptoms (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.39–2.46), headache/migraine (OR = 2.04, 95% CI: 1.53–2.72), frequent infections (OR = 1.75, 95% CI: 1.14–2.70), and musculoskeletal symptoms (OR = 1.70, 95% CI: 1.30–2.23) than women who did not report mental stress. Women without these symptoms at baseline 1968–1969, but with perceived mental stress were more likely to subsequently report incident abdominal symptoms (OR = 2.15, 95% CI: 1.39–3.34), headache/migraine (OR = 2.27, 95% CI: 1.48–3.48) and frequent infections (OR = 2.21, 95% CI: 1.12–4.36) in 1974–1975 than women without mental stress in 1968–1969. There was no association between perceived mental stress at baseline and mortality over 37 years of follow-up. Conclusion: Women reporting mental stress had a higher frequency of psychosomatic symptoms than women who did not report these symptoms. Not working outside home and smoking rather than low socioeconomic status per se was associated with higher stress levels. Perception of high mental stress was not associated with increased mortality. Keywords: cardiovascular disease, mental stress, mortality, psychosomatic symptoms, population study, women