Journal Article

Sex-specific Relationship Between Stress Coping Strategies and All-cause Mortality: Japan Multi-Institutional Collaborative Cohort Study

Kato, Yasufumi, Shimanoe, Chisato, Nishimoto, Daisaku, Otonari, Jun, Ozaki, Etsuko, Koyanagi, Yuriko N., Okada, Rieko, Ikezaki, Hiroaki, Watanabe, Isao, Hishida, Asahi, Katsuura-Kamano, Sakurako, Kusakabe, Miho, Shibuya, Keiichi, Tamura, Takashi, Kadota, Aya, Arisawa, Kokichi, Nagayoshi, Mako, Tamada, Yudai, Suzuki, Sadao, Kuriki, Kiyonori, Takashima, Naoyuki, Kubo, Yoko, Mikami, Haruo, Nishida, Yuichiro, Wakai, Kenji, Nishiyama, Takeshi, Takeuchi, Kenji, Matsuo, Keitaro

2023

Overview

Background: Stress coping strategies are related to health outcomes. However, there is no clear evidence for sex differences between stress-coping strategies and mortality. We investigated the relationship between all-cause mortality and stress-coping strategies, focusing on sex differences among Japanese adults.Methods: A total of 79,580 individuals aged 35–69 years participated in the Japan Multi-Institutional Collaborative Cohort Study between 2004 and 2014 and were followed up for mortality. The frequency of use of the five coping strategies was assessed using a questionnaire. Sex-specific, multivariable-adjusted hazard ratios (HRs) for using each coping strategy (“sometimes,” and “often/very often” use versus “very few” use) were computed for all-cause mortality. Furthermore, relationships were analyzed in specific follow-up periods when the proportion assumption was violated.Results: During the follow-up (median: 8.5 years), 1,861 mortalities were recorded. In women, three coping strategies were related to lower total mortality. The HRs for “sometimes” were 0.81 (95% confidence interval [CI], 0.67–0.97) for emotional expression, 0.79 (95% CI, 0.66–0.95) for emotional support-seeking, and 0.80 (95% CI, 0.66–0.98) for disengagement. Men who “sometimes” used emotional expression and sometimes or often used problem-solving and positive reappraisal had a 15–41% lower HRs for all-cause mortality. However, those relationships were dependent on the follow-up period. There was evidence that sex modified the relationships between emotional support-seeking and all-cause mortality (P for interaction = 0.03).Conclusion: In a large Japanese sample, selected coping strategies were associated with all-cause mortality. The relationship of emotional support-seeking was different between men and women.

• Publisher: Japan Epidemiological Association
• Subject: all-cause mortality / Cohort analysis / Collaboration / Coping / Emotions / Gender differences / Japan / Men / Mortality / Original / perceived stress / Problem solving / Public Health / Sex differences / Social support / stress coping strategies / Women