Are maddies sicker?

Found: Sick leave for mental illness linked to early death. This is consistent with the view that there is a general syndrome of better biological functioning. "To him that hath, more will be given him; to him that hath not what little he hath not will be taken away". We also see it in the better health of high IQ people, for instance. A more straightforward explanation, however, is that mad people are more likely to harm themselves, whether accidentally or deliberately

People who need to take time off from work for a mental health problem may live shorter lives than those in better psychiatric health, a new study suggests. Researchers found that among nearly 20,000 French workers they followed, those who'd taken at least 1 week's sick leave for a mental health disorder had a higher death rate over 14 years.

At the outset, 41 percent of the workers -- all public utility employees -- had taken at least 1 week's sick leave over the past 3 years. Those who'd taken time off specifically for depression or other mental health disorders were one quarter to one third more likely to die over the study period than workers with no mental-health absences. "Basically the message is that workers with medically certified absences for mental diagnoses should be considered a population at a higher risk of fatal disease," lead researcher Dr. Jane E. Ferrie, of the University College London in the UK, told Reuters Health.

She stressed, however, that the findings point to a relatively higher death rate in this group as a whole -- and that does not mean that any one person with a mental health disorder has an unusually high risk of early death. When studies observe large populations over time to look for patterns, the results cannot be used to "infer risk at the level of the individual," Ferrie explained.

The findings, published in the Journal of Epidemiology and Community Health, are based on 19,235 public utility employees (5271 female) who were part of long-range health study. The researchers used employment records to verify any medically certified work absences the employees had between 1990 and 1992. (French law requires workers to get a medical certificate from their doctors for each day of sick leave.)

Between 1993 and 2007, there were 902 deaths among the study participants. Those who'd taken 7 days or more off from work for a mental health disorder had a higher risk of death, even when their age and type of job were taken into account.

With the exception of extreme cases, mental health problems do not, in themselves, kill people, Ferrie pointed out. Instead, she explained, poor mental health is often connected to poor physical health. On one hand, physical conditions may lead to depression or other mental health problems, Ferrie noted. On the other, psychiatric conditions may directly impair physical health, possibly by affecting the nervous and hormonal systems.

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ANOTHER CONFIRMATION THAT THE POOR ARE SICKER

This too is consistent with a pattern of general biological fitness

Co-occurrence of risk factors for cardiovascular disease by social class: 1958 British birth cohort

By C Power et al.

Aim: To establish whether social differences in multiple risk factors for cardiovascular disease are due to a greater strength of association (higher correlation) between risk factors in less advantaged groups.

Methods: Co-occurrence of five risk factors (smoking, hypertension, low high-density lipoprotein cholesterol, obesity, diabetes) in 3614 British 45-year-old men and 3560 women in the manual and non-manual social groups.

Results: 4.0% of women in manual groups had 3 or more risk factors compared with 1.7% in non-manual groups: 6.2% and 3.4% respectively for men. There was a higher than expected percentage of the population, overall, with 3 or more risk factors assuming independence between risk factors; correspondingly, there was a slightly lower than expected proportion with one factor. However, patterns of observed to expected ratios were consistent in manual and non-manual groups and did not differ by the number of risk factors.

Conclusions: Higher prevalence of multiple risk factors in manual groups was due to the higher prevalence of individual factors rather than a greater tendency of those with an individual risk factor to have additional risks. Strategies to reduce multiple risk factors in less advantaged groups would help to lessen their health burden.

Journal of Epidemiology and Community Health 2008;62:1030-1035