PEOPLE really can worry themselves to death, according to the largest study ever to link distress and mortality.
Research published today found even low levels of stress, which patients would rarely discuss with their doctor, raised the risk of dying, particularly from heart disease and strokes.
The authors have called for experts to investigate whether treating the mildest forms of anxiety can prolong lives.
One-quarter of all adults are said to suffer from the symptoms, which include losing sleep due to worry and struggling to concentrate.
Teams at Edinburgh University and University College London looked at records for 68,000 adults who had participated in the national health survey to see how anxiety scored related to chances of survival.
Dr Tom Russ, an expert in old-age psychiatry at Edinburgh University and the lead author, said: "We found psychological distress was a risk factor for death from all causes ... the greater the distress, the higher the risk.
"However, even people with low distress scores were at an increased risk of death."
The health survey assigns scores for mental health, with zero indicating no issues and scores above three indicating a medical problem.
Mr Russ and his team found those who scored as low as one to three were 16% more likely to die from any cause, including accidents and suicides, than those who scored zero.
Furthermore, they were 25% more likely to die from cardiovascular disease. Weight, smoking and alcohol consumption were taken into account.
Dr David Batty, senior author of the study, which is published in the British Medical Journal, said: "This increased mortality is not simply the result of people with higher levels of psychological distress smoking or drinking more, or taking less exercise."
Deaths from cancer were not linked to low stress levels to the same extent as cardiovascular disease, but there was still a 9% increased risk.
How the body responds to mental stress is still subject to speculation, although it is widely thought it can heighten signs of inflammation, which are also associated with disease.
Dr Russ said: "The fact an increased risk of mortality was evident, even at low levels of psychological distress, should prompt research into whether treatment of these very common, minor symptoms can modify this increased risk of death."
He said he was not advocating prescribing antidepressants for those people with low scores, but said the findings showed the symptoms should be taken seriously.
Exercise for those who do not already take part in sport may help, he said, as could learning some cognitive behaviour therapy techniques.
However, he stressed the impact of these on very low levels of distress had not been tested.
Carolyn Roberts, head of policy for the Scottish Association for Mental Health, said people should not panic about the findings as there were many different risk factors for cardiovascular disease.
She said: "It reminds us how important it is for people to be aware of how they manage their mental health even if they do not think of themselves as someone who has a mental health problem. It also shows GPs and people in primary care need the training and information on lower levels of mental distress and know how to signpost people."
The research used data from the Health Survey for England.
A similar study using Scottish Health Survey results is under way.
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