Association between self-reported stressful feeling by SACL and mortality in a Japanese community

A cohort study consisting of 4,291 residents of a Japanese community has been conducted since 1987. The associations between stressful feelings measured by Stress Arousal Checklist (SACL) and mortality of all causes and cancer were examined. The relative risks (RRs) for mortality for 7 years for high stressful state (SACL score: 7-17) and moderate stressful state (3-6) subjects compared with low stressful state subjects (0-2) were 1.1 (95% CI = 0.69-1.68), 1.3 (95% CI = 0.85-2.00) for all causes and 1.5 (95% CI = 0.80-2.99), 1.3 (95% CI = 0.67-2.61) for cancer respectively, after being adjusted for sex, age, smoking, drinking, exercise and medical-care use. When each item of the SACL was examined independently, six out of 17 items of SACL which were "not comfortable", "not contented", "not cheerful", "dejected", "nervous", "not pleasant" showed elevated RRs for all causes of mortality with statistical significance (RRs: 1.4, 1.4, 1.7, 1.7, 1.5, 1.5, respectively), after being adjusted for the possible confounding factors stated above. Especially, the adjusted RRs of "not cheerful" and "dejected" for all causes was 1.7 (95% CI = 1.20-2.33), 1.7 (95% CI = 1.17-2.46), respectively. The results suggested that stressful feelings of "not cheerful" and "dejected" might increase mortality.