Psychological effects of hypertension labelling during a community survey. A two-year follow-up

The possibility that subjects examined during a population screening programme may develop psychological disturbances as a consequence of being labelled as hypertensives has been investigated. The Symptom Rating Test (SRT) for the assessment of neurotic symptoms was completed by 210 screenees. Aware hypertensives were excluded from the study. It was subsequently found that 81 subjects had raised BP (systolic greater than or equal to 160 or diastolic greater than or equal to 95 mmHg; group 1), and 129 subjects were 'normotensive' (group 2). The total SRT score was significantly higher in group 2 than in group 1. After screening, all subjects were returned to their GPs, and 82% of them were re-examined 2 years later. SRT scores were significantly lower than the initial ones in both groups. At re-examination 35% of 'hypertensives', were found to have 'normal' BP values. The SRT scores of these falsely-labelled subjects were similar to those of the subjects found still to be hypertensive. These findings suggest that subjects with raised BP at screening have lower neuroticism scores than normotensives. More importantly still, hypertension labelling, whether 'true' or 'false', does not have any negative long-term psychological consequences.