Mortality among persons with depressive symptoms and among responders and non-responders in a health check-up. An investigation of persons born in 1905 and followed up from age 66 to 75.

The death rate for persons in Stockholm born in 1905 has been investigated during a 9-year period (1971-1979). In 1971 these persons were invited to participate in a health check-up. Another check-up was carried out 3 years later, during which a psychiatric examination of 589 persons was undertaken. The correlation between depressive disorders and mortality was investigated in two steps. The death rates for those subjects who had responded affirmatively to items in a questionnaire indicating depression were compared with the death rate for the remaining responders. The death rates for those subjects considered to have neurotic disorders or sleeping disturbances in the psychiatric examination were compared with the death rates for the members of a control group considered to be without psychiatric symptoms. Both methods gave fundamentally the same result: there is an excess mortality among persons with depressive symptoms compared to persons without. The death rates were significantly higher in the populations that did not participate in the health check-ups than in those who did. The rates of suicide were also greater in the non-response populations. None of the persons who participated in the 1974 health check-up committed suicide during the next 3 years. The study shows that physically and mentally healthier persons were overrepresented among those who participated in the health check-ups at the ages of 66 and 69.