Martín-María Natalia, Miret Marta, Caballero Francisco Félix, Rico-Uribe Laura Alejandra, Steptoe Andrew, Chatterji Somnath, Ayuso-Mateos José Luis
From the Department of Psychiatry (Martín-María, Miret, Caballero, Rico-Uribe, Ayuso-Mateos), Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III (Martín-María, Miret, Caballero, Rico-Uribe, Ayuso-Mateos), Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Psychiatry (Martín-María, Miret, Caballero, Rico-Uribe, Ayuso-Mateos), Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria (IIS-La Princesa), Madrid, Spain; Department of Epidemiology and Public Health (Steptoe), University College London, United Kingdom; and Department of Information (Chatterji), Evidence and Research, World Health Organization, Geneva, Switzerland.
Psychosom Med. 2017 Jun;79(5):565-575. doi: 10.1097/PSY.0000000000000444.
The aims of the study were to assess whether subjective well-being is a protective factor for mortality in the general population and to analyze the differential impact of evaluative, experienced, and eudaimonic well-being.
Systematic review of articles in the PsycINFO, Web of Science, and PubMed databases. Data on the studies' characteristics, quality, and the effects of variables were extracted. A meta-analysis was conducted on the studies included in the systematic review.
A total of 62 articles that investigated mortality in general populations, involving 1,259,949 participants, were found, and added to those considered in a previously published review (n = 14). The meta-analysis showed that subjective well-being was a protective factor for mortality (pooled hazard ratio = 0.920; 95% confidence interval = 0.905-0.934). Although the impact of subjective well-being on survival was significant in both men and women, it was slightly more protective in men. The three aspects of subjective well-being were significant protective factors for mortality. The high level of heterogeneity and the evidences of publication bias may reduce the generalizability of these findings.
Our results suggest that subjective well-being is associated with a decreased risk of mortality. Longitudinal studies examining changing levels of well-being and their relationship to longevity would be required to establish a cause-effect relationship. Establishing such a causal relationship would strengthen the case for policy interventions to improve the population subjective well-being to produce longevity gains combined with optimizing quality of life.
本研究旨在评估主观幸福感是否为普通人群死亡率的保护因素，并分析评价性、体验性和心理幸福感的差异影响。
对PsycINFO、科学网和PubMed数据库中的文章进行系统综述。提取有关研究特征、质量和变量影响的数据。对系统综述中纳入的研究进行荟萃分析。
共发现62篇调查普通人群死亡率的文章，涉及1,259,949名参与者，并将其纳入先前发表的综述中考虑的文章（n = 14）。荟萃分析表明，主观幸福感是死亡率的保护因素（合并风险比 = 0.920；95%置信区间 = 0.905 - 0.934）。尽管主观幸福感对男性和女性的生存影响均显著，但对男性的保护作用稍强。主观幸福感的三个方面都是死亡率的显著保护因素。高度的异质性和发表偏倚的证据可能会降低这些发现的普遍性。
我们的结果表明，主观幸福感与死亡率风险降低有关。需要进行纵向研究来考察幸福感水平的变化及其与长寿的关系，以建立因果关系。建立这样的因果关系将加强政策干预的理由，即通过提高人群主观幸福感来实现长寿增长并优化生活质量。
