Goldberg E L, Comstock G W
Am J Epidemiol. 1976 Aug;104(2):146-58. doi: 10.1093/oxfordjournals.aje.a112285.
The objective was to examine for relationships between stress, as measured by life events, and hospitalization or death during the following 6 to 12 months, using a case-control design. As part of the Community Mental Epidemiology Program, life events data for the preceding year were gathered on a random sample of the population at two sites, and health data for the interval between interviews were collected at follow-up. A case is defined as anyone becoming ill and being hospitalized or dying during the interval between interviews. Each case was individually matched by several variables to a control who had neither been sick nor hospitalized. There were no significant demographic differences between cases and control in either site or between sites. When life events were examined by various scoring methods, there were no differences between cases and controls. This finding is important since most longitudinal studies that have shown a positive relationship between life events and subsequent illness have had methodologic limitations or have been based on healthy, young, male populations who generally did not become seriously ill during the study period. The results of this study plus the lack of generalizability of previous findings and their somewhat conflicting results raise serious questions about the etiologic relationship of life events to subsequent illness.
研究目的是采用病例对照设计，考察以生活事件衡量的压力与接下来6至12个月内住院或死亡之间的关系。作为社区精神流行病学项目的一部分，在前一年从两个地点的人群中随机抽取样本收集生活事件数据，并在随访时收集两次访谈期间的健康数据。病例定义为在两次访谈期间生病并住院或死亡的任何人。每个病例通过几个变量与既未生病也未住院的对照进行个体匹配。病例与对照在任何一个地点或不同地点之间在人口统计学上均无显著差异。当用各种计分方法检查生活事件时，病例与对照之间没有差异。这一发现很重要，因为大多数显示生活事件与后续疾病之间存在正相关关系的纵向研究都存在方法学上的局限性，或者是基于健康、年轻的男性人群，而这些人群在研究期间通常不会患上重病。本研究结果加上先前研究结果缺乏普遍性以及它们有些相互矛盾的结果，引发了关于生活事件与后续疾病病因关系的严重问题。
