Psychosocial stress impairs health behavior in patients with mental disorders

It has been shown, that in the general population psychosocial stress affects health behaviors. However similar studies of high risk populations are sparse. Therefore, the aim of this cross-sectional study is to analyze the association between common psychosocial stressors and health behavior in a sample of patients with mental disorders.

We analyzed data of n = 2326 outpatients from a mental health care department. Severity of psychosocial stress was assessed by the PHQ-stress module of the Patient Health Questionnaire (PHQ). Health behaviors included obesity, uncontrolled eating, smoking and physical inactivity. Multiple binary regression models were conducted for the PHQ-stress score and for each of the ten PHQ-stress items as independent variables.

'Financial stress' and 'having no one to turn to with problems' were mainly associated with adverse health behaviors after adjustment for multivariate effects. The most affected health behaviors were uncontrolled eating in both sexes and obesity in women.

Our findings indicate specific influences of psychosocial stressors on unhealthy behaviors in a clinical sample. Patients with financial strain and lack of social support might need specific support for improving their health behavior.