Sex-specific Relationship Between Stress Coping Strategies and All-cause Mortality: Japan Multi-Institutional Collaborative Cohort Study

Autor: Etsuko Ozaki, Rieko Okada, Yuichiro Nishida, Kusakabe Miho, Kokichi Arisawa, Kiyonori Kuriki, Mikami Haruo, Yoko Kubo, Naoyuki Takashima, Yuriko N. Koyanagi, Keitaro Matsuo, Kato Yasufumi, Isao Watanabe, Kenji Takeuchi, Hiroaki Ikezaki, Takeshi Nishiyama, Sadao Suzuki, Keiichi Shibuya, Yudai Tamada, Mako Nagayoshi, Aya Kadota, Chisato Shimanoe, Takashi Tamura, Kenji Wakai, Sakurako Katsuura-Kamano, Asahi Hishida, Jun Otonari, Daisaku Nishimoto
Rok vydání: 2023
Předmět:
Zdroj: Journal of Epidemiology. 33:236-245
ISSN: 1349-9092
0917-5040
Popis: Background Stress coping strategies are related to health outcomes. However, there is no clear evidence for sex differences between stress-coping strategies and mortality. We investigated the relationship between all-cause mortality and stress-coping strategies, focusing on sex differences among Japanese adults. Methods A total of 79,580 individuals aged 35-69 years participated in the Japan Multi-Institutional Collaborative Cohort Study between 2004 and 2014 and were followed up for mortality. The frequency of use of the five coping strategies was assessed using a questionnaire. Sex-specific, multivariable-adjusted hazard ratios (HRs) for using each coping strategy "sometimes," and "often/very often" (versus "very few" use) were computed for all-cause mortality. Furthermore, relationships were analyzed in specific follow-up periods when the proportion assumption was violated. Results During the follow-up (median: 8.5 years), 1,861 mortalities were recorded. In women, three coping strategies were related to lower total mortality. The HRs (95% confidence intervals) for "sometimes" were 0.81 (0.67-0.97) for emotional expression, 0.79 (0.66-0.95) for emotional support-seeking, and 0.80 (0.66-0.98) for disengagement. Men who "sometimes" used emotional expression and sometimes or often used problem-solving and positive reappraisal had a 15-41% lower HRs for all-cause mortality. However, those relationships were dependent on the follow-up period. There was evidence that sex modified the relationships between emotional support-seeking and all-cause mortality (p for interaction = 0.03). Conclusions In a large Japanese population, selected coping strategies were associated with all-cause mortality. The relationship of emotional support-seeking was different between men and women.
Databáze: OpenAIRE
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