Objectives

Childhood adversities may be important determinants of later illnesses and poor health behaviour. However, large-scale prospective studies on the associations between childhood adversities and the onset of asthma in adulthood are lacking.

Design

Prospective cohort study with 7-year follow-up.

Setting

Nationally representative study. Data were collected from the Health and Social Support (HeSSup) survey and national registers.

Participants

The participants represent the Finnish population from the following age groups: 20–24, 30–34, 40–44, and 50–54 years at baseline in 1998 (24 057 survey participants formed the final cohort of this study). The occurrence of childhood adversities was assessed at baseline with a six-item survey scale. The analyses were adjusted for sociodemographic characteristics, behavioural health risks and common mental disorders.

Primary and secondary outcomes

The survey data were linked to data from national health registers on incident asthma during a 7-year follow-up to define new-onset asthma cases with verified diagnoses.

Results

A total of 12 126 (59%) participants reported that they encountered a childhood adversity. Of them 3677 (18% of all) endured three to six adversities. During a follow-up of 7 years, 593 (2.9%) participants were diagnosed with incident asthma. Those who reported three or more childhood adversities had a 1.6-fold (95% CI 1.31 to 2.01) greater risk of asthma compared to those without childhood adversities. This hazard attenuated but remained statistically significant after adjustment for conventional risk factors (HR 1.33; 95% CI 1.06 to 1.67).

Conclusions

Adults who report having encountered adversities in childhood may have an increased risk of developing asthma.

BACKGROUND

Depression and mortality have been studied separately in patients with coronary heart disease (CHD) and in populations healthy at study inception. This does not allow comparisons across risk-factor groups based on the cross-classification of depression and CHD status.

OBJECTIVE

To examine effects of depressive symptoms and coronary heart disease and their interactive associations on mortality in middle-aged adults followed over 5.6 years.

DESIGN AND SETTING

A prospective population-based cohort study of 5936 middle-aged men and women from the British Whitehall II study. We created 4 risk-factor-groups based on the cross classification of depressive symptoms and CHD status.

RESULTS

The age- and sex-adjusted hazard ratios for death from all causes were 1.67 (p<0.05) for participants with only CHD, 2.10 (p<0.001) for those with only depressive symptoms and 4.99 (p<0.001) for those with both CHD and depressive symptoms when compared to participants without either condition. The two latter risk-factor groups remained at increased risk after adjustments for relevant confounders. The relative excess risk due to the interaction between depressive symptoms and CHD for all-cause mortality was 3.58 (95% CI, −0.09–7.26), showing some evidence of an additive interaction. A similar pattern was also observed for cardiovascular death.

CONCLUSIONS

This study provides evidence that depressive symptoms are associated with an increased risk of all-cause and cardiovascular death and that this risk is particularly marked in depressive participants with co-morbid CHD.

Background and Purpose

The association between optimism and pessimism and health outcomes has attracted increasing research interest. To date, the association between these psychological variables and risk of stroke remains unclear. We examined the relationship between pessimism and the 7-year incidence of stroke.

Methods

A random sample of 23 216 adults (9 480 men, 13 796 women) aged 20–54 years completed the pessimism scale in 1998, i.e., at study baseline. Fatal and first non-fatal stroke events during a mean follow-up of 7.0 years were documented by linkage to the National-hospital-discharge and mortality registers, leading to 105 events.

Results

Unadjusted hazard ratio was 0.44 (95% CI 0.25–0.77) for participants in the lowest quartile (a low pessimism level) when compared to those in the highest quartile (a high pessimism level). After serial adjustments for sociodemographic characteristics, cardiovascular biobehavioral risk factors, depression, general feeling of stressfulness, and ischemic-heart disease the fully-adjusted hazard ratio was 0.52 (95% CI 0.29–0.93).

Conclusions

In this population of adult men and women, low level of pessimism had a robust association with reduced incidence of stroke.