Self-reported hostility and suicidal acts, accidents, and accidental deaths: a prospective study of 21,443 adults aged 25 to 59.

The association of self-reported hostility with morbidity and mortality due to external causes, including suicidal acts, was analyzed in 10,586 Finnish men and 10,857 Finnish women aged 24 to 59 years. Hostility was assessed from self-ratings on irritability, ease of anger-arousal, and argumentativeness. Three groups, low (33.6% of subjects), intermediate (50.6%), and extreme (15.9%), were formed from the self-reported hostility scores. A 6-year mortality follow-up yielded 76 violent deaths among men and 11 among women. A 4-year morbidity follow-up found 399 hospitalizations due to external causes among men and 169 among women. Among men, the risk ratio between the highest and lowest hostility groups was 1.51 (95% confidence interval, 1.16-1.96) for all events due to external causes and 3.6 (95% confidence interval, 1.63-7.89) for suicidal behavior, when effects of age, marital status, social status, and self-reported alcohol use were controlled in a multivariate model. No association was observed between traffic-related injuries and hostility. Hostility did not predict accidents or accidental deaths or suicidal behavior among women.