Boyle Stephen H, Michalek Joel E, Suarez Edward C
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Psychosom Med. 2006 Nov-Dec;68(6):844-50. doi: 10.1097/01.psy.0000240779.55022.ff. Epub 2006 Nov 1.
The purpose of the present investigation was to examine the prospective associations of hostility, anger, depression, and anxiety, alone and in combination, to incident coronary heart disease (CHD).
Subjects were 2105 men who participated in the Air Force Health Study, a 20-year study designed to evaluate the effects of herbicide exposure on various health outcomes in Air Force veterans of Operation Ranch Hand. Psychological attributes were assessed in 1985 using scales constructed from the Minnesota Multiphasic Personality Inventory. Participants were followed for an average of 15 years for evidence of ischemic heart disease (International Classification of Diseases codes 410-414, 428.4, or 36). The relation between psychological attributes and CHD was examined with Cox proportional hazard models.
Adjusting for CHD risk factors, depression, anxiety, hostility, and trait anger were significant predictors of incident CHD. In addition, a factor analytically derived psychological risk factor composite score was the strongest predictor of CHD.
These results suggest that the covariation of hostility, anger, depression, and anxiety accounts for the increased risk of CHD associated with each individual factor. The results of this study challenge the conventional approach of examining these psychological attributes in isolation.
本研究旨在探讨敌意、愤怒、抑郁和焦虑单独及合并存在时与冠心病（CHD）发病之间的前瞻性关联。
研究对象为2105名男性，他们参与了空军健康研究，这是一项为期20年的研究，旨在评估除草剂暴露对“牧场工行动”空军退伍军人各种健康结局的影响。1985年使用明尼苏达多相人格调查表编制的量表对心理特征进行评估。对参与者平均随访15年，观察缺血性心脏病（国际疾病分类代码410 - 414、428.4或36）证据。采用Cox比例风险模型研究心理特征与冠心病之间的关系。
校正冠心病危险因素后，抑郁、焦虑、敌意和特质愤怒是冠心病发病的显著预测因素。此外，通过因素分析得出的心理危险因素综合评分是冠心病最强的预测因素。
这些结果表明，敌意、愤怒、抑郁和焦虑的共同变化导致了与每个个体因素相关的冠心病风险增加。本研究结果挑战了孤立地研究这些心理特征的传统方法。
