Purpose: Previous research has shown a significant association between psychological distress (PD) and all-cause mortality. However, this association is not fully explored, and life expectancy by PD is unknown.
Methods: We used the pooled 1997-2014 data from the National Health Interview Survey linked to National Death Index (n = 513,081) to examine the association of the Kessler 6-item PD scale with life expectancy and all-cause mortality. Life expectancy by PD was computed using the standard life table method. Cox regression was used to model survival time as a function of PD and sociodemographic, behavioral, and health characteristics.
Results: The age-adjusted mortality rate for adults with serious PD (SPD) was 2632 deaths per 100,000 person-years, compared with 1428 for those without PD. Life expectancy was inversely related to PD. At age 18, those with SPD had a life expectancy of 45.0 years, compared with 55.6 years for those without PD. The age-adjusted relative risk of all-cause mortality was 125% higher for adults with SPD (hazard ratio = 2.25; 95% confidence interval = 2.14, 2.37) than those without PD. Mortality risk associated with SPD remained (hazard ratio = 1.14; 95% confidence interval = 1.08, 1.20) after covariate adjustment.
Conclusions: U.S. adults with SPD had significantly higher mortality risk and lower life expectancy.
Keywords: All-cause mortality; Life expectancy; Longitudinal; NHIS-NDI; Psychological distress.
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