Martín-María Natalia, Caballero Francisco Félix, Olaya Beatriz, Rodríguez-Artalejo Fernando, Haro Josep Maria, Miret Marta, Ayuso-Mateos José Luis
Department of Psychiatry, School of Medicine, Universidad Autónoma de MadridMadrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de La PrincesaMadrid, Spain.
Department of Psychiatry, School of Medicine, Universidad Autónoma de MadridMadrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de La PrincesaMadrid, Spain; CIBER of Mental HealthMadrid, Spain.
Front Psychol. 2016 Jul 12;7:1040. doi: 10.3389/fpsyg.2016.01040. eCollection 2016.
Some studies have analyzed the relation between well-being and mortality but none of them have attempted to disentangle the differential influence that positive affect, negative affect, and evaluative well-being might have on mortality using a longitudinal design in the general population and measuring independently and accurately each component of well-being. The aim of the present study is to assess the association of these well-being components with mortality after adjusting for health and other lifestyle factors and to analyze whether this association is different in people with and without depression.
A nationally representative sample of 4753 people from Spain was followed up after 3 years. Analyses were performed with Cox regression models among the total sample and separately in people with and without depression.
In the analyses adjusted for age, sex, and years of education, all three well-being variables showed separately a statistically significant association with mortality. However, after adjustment for health status and other confounders including the other well-being components, only positive affect remained as marginally associated with a decreased risk of mortality in the overall sample [HR = 0.87; 95% CI = 0.73-1.03], in particular among individuals without depression [HR = 0.82; 95% CI = 0.68-0.99].
Positive affect is inversely associated with mortality in individuals without depression. Future research should focus on assessing interventions associated with a higher level of positive affect.
一些研究分析了幸福感与死亡率之间的关系，但没有一项研究试图在一般人群中采用纵向设计，并独立且准确地测量幸福感的各个组成部分，以厘清积极情绪、消极情绪和评价性幸福感对死亡率可能产生的不同影响。本研究的目的是在调整健康和其他生活方式因素后，评估这些幸福感组成部分与死亡率之间的关联，并分析这种关联在有抑郁症和无抑郁症的人群中是否存在差异。
对来自西班牙的4753名具有全国代表性的人群进行了为期3年的随访。在总样本以及有抑郁症和无抑郁症的人群中分别使用Cox回归模型进行分析。
在对年龄、性别和受教育年限进行调整后的分析中，所有三个幸福感变量分别显示出与死亡率有统计学意义的关联。然而，在调整健康状况和其他混杂因素（包括其他幸福感组成部分）后，在总体样本中，只有积极情绪与死亡率降低的风险仍有微弱关联[风险比（HR）=0.87；95%置信区间（CI）=0.73-1.03]，特别是在无抑郁症的个体中[HR=0.82；95%CI=0.68-0.99]。
在无抑郁症的个体中，积极情绪与死亡率呈负相关。未来的研究应侧重于评估与更高水平积极情绪相关的干预措施。
