Single item on positive affect is associated with 1-year survival in consecutive medical inpatients.

OBJECTIVE To determine the independent effects of positive and negative affect items on mortality in consecutive medical inpatients. METHODS Consecutive general medical inpatients were asked to complete the Hospital Anxiety and Depression Scale (HADS) at admission. Prognostic indicators were obtained from patients' records and physicians' ratings. The study end point was mortality from all causes at 1 year. RESULTS The baseline assessment was completed by 575 patients (87.7%). Survival data were available for 572 of these (86 deaths). HADS depression scores and several physical risk indicators predicted mortality. Independent effects could be observed for HADS item 1 ("Can enjoy things as much as before") adjusted for physicians' ratings of prognosis, a principal diagnosis of hemato-oncological disease and Charlson comorbidity scores. In contrast, HADS depression items 2-7 (Model 1) as well as positive HADS depression scores did not contribute significantly to the prediction of mortality. CONCLUSION Our present results suggest that one single item on positive affect independently predicts 1-year survival in consecutively admitted medical inpatients. Interestingly, this item has a stronger association with survival status than the presence of depressed mood.

[1]  F. Zitman,et al.  Dispositional optimism and the risk of cardiovascular death: the Zutphen Elderly Study. , 2006, Archives of internal medicine.

[2]  R. Geenen,et al.  Psychological adjustment to chronic disease , 2008, The Lancet.

[3]  L. Kubzansky,et al.  Psychologic functioning and physical health: a paradigm of flexibility. , 2005, Psychosomatic medicine.

[4]  T. Strandberg,et al.  Positive life orientation as a predictor of 10-year outcome in an aged population. , 2004, Journal of clinical epidemiology.

[5]  J. Gold,et al.  Validation of a combined comorbidity index. , 1994, Journal of clinical epidemiology.

[6]  A. Mykletun,et al.  Anxiety, Depression, and Cause-Specific Mortality: The HUNT Study , 2007, Psychosomatic medicine.

[7]  F. Zitman,et al.  Dispositional optimism and all-cause and cardiovascular mortality in a prospective cohort of elderly dutch men and women. , 2004, Archives of general psychiatry.

[8]  Judith E. Rink,et al.  Implications for Practice and Research , 1996 .

[9]  J. Russell,et al.  Core affect, prototypical emotional episodes, and other things called emotion: dissecting the elephant. , 1999, Journal of personality and social psychology.

[10]  J. Moskowitz,et al.  Positive Affect Predicts Lower Risk of AIDS Mortality , 2003, Psychosomatic medicine.

[11]  S. Zipfel,et al.  Depression increasingly predicts mortality in the course of congestive heart failure , 2005, European journal of heart failure.

[12]  Sheldon Cohen,et al.  Does positive affect influence health? , 2005, Psychological bulletin.

[13]  C. Herrmann-Lingen,et al.  Depressed mood, physician-rated prognosis, and comorbidity as independent predictors of 1-year mortality in consecutive medical inpatients. , 2001, Journal of psychosomatic research.

[14]  M. Watson,et al.  Influence of psychological response on survival in breast cancer: a population-based cohort study , 1999, The Lancet.

[15]  L. George,et al.  Depression and physical disability outcomes in depressed medically ill hospitalized older adults. , 1998, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[16]  R. Snaith,et al.  The hospital anxiety and depression scale. , 2013, Acta psychiatrica Scandinavica.

[17]  Thomas E. Moritz,et al.  Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery. , 1999, JAMA.

[18]  E. Leibing,et al.  Diagnostic Groups and Depressed Mood as Predictors of 22-Month Mortality in Medical Inpatients , 1998, Psychosomatic medicine.

[19]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[20]  G. Parkerson,et al.  Health-Related Quality of Life Predictors of Survival and Hospital Utilization , 2000, Health care financing review.

[21]  R. Thurston,et al.  Emotional vitality and incident coronary heart disease: benefits of healthy psychological functioning. , 2007, Archives of general psychiatry.

[22]  D. Shapiro,et al.  Immunological and physiological changes associated with induced positive and negative mood. , 1994, Psychosomatic medicine.

[23]  P. Vokonas,et al.  Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study , 2001, Psychosomatic medicine.

[24]  H. Mandin,et al.  Psychosocial Predictors of Survival in End‐Stage Renal Disease , 1990, The Journal of nervous and mental disease.

[25]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[26]  E. Lusk,et al.  Psychosocial correlates of survival in advanced malignant disease? , 1985, The New England journal of medicine.

[27]  B. Fredrickson.  What Good Are Positive Emotions? , 1998, Review of general psychology : journal of Division 1, of the American Psychological Association.

[28]  Thomas E. Moritz,et al.  Health-Related Quality of Life As a Predictor of Mortality Following Coronary Artery Bypass Graft Surgery , 1999, Survey of Anesthesiology.

[29]  C. Herrmann.  International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. , 1997, Journal of psychosomatic research.

[30]  S A Black,et al.  Emotional Well‐Being Predicts Subsequent Functional Independence and Survival , 2000, Journal of the American Geriatrics Society.