Perceived psychological stress and risk of herpes zoster: a nationwide population-based cohort study

S. A.J. Schmidt; H. T. Sørensen; S. M. Langan; M. Vestergaard

doi:10.1111/bjd.19832

Perceived psychological stress and risk of herpes zoster: a nationwide population-based cohort study

S. A.J. Schmidt^*, H. T. Sørensen, S. M. Langan, M. Vestergaard

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

18 Citationer (Scopus)

44 Downloads (Pure)

Abstract

Background: Psychological stress may reduce cellular immunity, but its role in triggering latent infections, including herpes zoster (HZ), is controversial. Objectives: To examine the association between perceived psychological stress and risk of HZ. Methods: In a linked registry-based cohort study, we followed 77 310 persons aged 40 years or older who participated in the 2010 Danish National Health Survey from 1 May 2010 until HZ diagnosis, death, emigration or 1 July 2014, whichever occurred first. We computed hazard ratios (HRs) of HZ associated with Cohen’s Perceived Stress Scale (PSS) score (range 0–40) using Cox regression with age as the timescale, adjusted for sex, immunosuppressive and selected chronic conditions, immunosuppressive drugs, and sociodemographic, lifestyle and anthropometric factors. The PSS measures chronic stress perceived by an individual in response to various demands of daily life. We modelled the PSS score using quintiles and a restricted cubic spline function. Results: The unadjusted rate of HZ varied from 5·53 to 7·20 per 1000 person-years from the lowest to the highest PSS score quintile. Compared with the lowest PSS score quintile, the adjusted HR for HZ was 1·00 [95% confidence interval (CI) 0·86–1·16], 1·08 (95% CI 0·92–1·26), 1·05 (95% CI 0·90–1·23) and 1·14 (95% CI 0·97–1·34) for the second to the fifth quintile, respectively. In cubic spline analyses, PSS scores < 20 were not associated with increased HR of HZ, but thereafter the HR increased linearly from 1·10 (95% CI 0·85–1·41) to 2·22 (95% CI 1·32–3·75). Conclusions: Our study indicated that high levels of psychological stress are associated with increased risk of HZ.

Originalsprog	Engelsk
Tidsskrift	British Journal of Dermatology
Vol/bind	185
Nummer	1
Sider (fra-til)	130-138
Antal sider	9
ISSN	0007-0963
DOI	https://doi.org/10.1111/bjd.19832
Status	Udgivet - jul. 2021

Adgang til dokumentet

10.1111/bjd.19832Licens: CC BY-NC

Br J Dermatol - 2021 - Schmidt - Perceived psychological stress and risk of herpes zoster a nationwide population%u2010basedForlagets udgivne version, 450 KBLicens: CC BY-NC

Andre filer og links

Link to publication in Scopus

Citationsformater

@article{066dfc64f18c4d84b127a9b9bea9a8bf,

title = "Perceived psychological stress and risk of herpes zoster: a nationwide population-based cohort study",

abstract = "Background: Psychological stress may reduce cellular immunity, but its role in triggering latent infections, including herpes zoster (HZ), is controversial. Objectives: To examine the association between perceived psychological stress and risk of HZ. Methods: In a linked registry-based cohort study, we followed 77 310 persons aged 40 years or older who participated in the 2010 Danish National Health Survey from 1 May 2010 until HZ diagnosis, death, emigration or 1 July 2014, whichever occurred first. We computed hazard ratios (HRs) of HZ associated with Cohen{\textquoteright}s Perceived Stress Scale (PSS) score (range 0–40) using Cox regression with age as the timescale, adjusted for sex, immunosuppressive and selected chronic conditions, immunosuppressive drugs, and sociodemographic, lifestyle and anthropometric factors. The PSS measures chronic stress perceived by an individual in response to various demands of daily life. We modelled the PSS score using quintiles and a restricted cubic spline function. Results: The unadjusted rate of HZ varied from 5·53 to 7·20 per 1000 person-years from the lowest to the highest PSS score quintile. Compared with the lowest PSS score quintile, the adjusted HR for HZ was 1·00 [95% confidence interval (CI) 0·86–1·16], 1·08 (95% CI 0·92–1·26), 1·05 (95% CI 0·90–1·23) and 1·14 (95% CI 0·97–1·34) for the second to the fifth quintile, respectively. In cubic spline analyses, PSS scores < 20 were not associated with increased HR of HZ, but thereafter the HR increased linearly from 1·10 (95% CI 0·85–1·41) to 2·22 (95% CI 1·32–3·75). Conclusions: Our study indicated that high levels of psychological stress are associated with increased risk of HZ.",

keywords = "DENMARK, SYSTEM, Humans, Risk Factors, Stress, Psychological/epidemiology, Herpesvirus 3, Human, Herpes Zoster/epidemiology, Cohort Studies, Incidence",

author = "Schmidt, {S. A.J.} and S{\o}rensen, {H. T.} and Langan, {S. M.} and M. Vestergaard",

note = "{\textcopyright} 2021 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.",

year = "2021",

month = jul,

doi = "10.1111/bjd.19832",

language = "English",

volume = "185",

pages = "130--138",

journal = "British Journal of Dermatology",

issn = "0007-0963",

publisher = "Oxford University Press",

number = "1",

}

TY - JOUR

T1 - Perceived psychological stress and risk of herpes zoster

T2 - a nationwide population-based cohort study

AU - Schmidt, S. A.J.

AU - Sørensen, H. T.

AU - Langan, S. M.

AU - Vestergaard, M.

PY - 2021/7

Y1 - 2021/7

N2 - Background: Psychological stress may reduce cellular immunity, but its role in triggering latent infections, including herpes zoster (HZ), is controversial. Objectives: To examine the association between perceived psychological stress and risk of HZ. Methods: In a linked registry-based cohort study, we followed 77 310 persons aged 40 years or older who participated in the 2010 Danish National Health Survey from 1 May 2010 until HZ diagnosis, death, emigration or 1 July 2014, whichever occurred first. We computed hazard ratios (HRs) of HZ associated with Cohen’s Perceived Stress Scale (PSS) score (range 0–40) using Cox regression with age as the timescale, adjusted for sex, immunosuppressive and selected chronic conditions, immunosuppressive drugs, and sociodemographic, lifestyle and anthropometric factors. The PSS measures chronic stress perceived by an individual in response to various demands of daily life. We modelled the PSS score using quintiles and a restricted cubic spline function. Results: The unadjusted rate of HZ varied from 5·53 to 7·20 per 1000 person-years from the lowest to the highest PSS score quintile. Compared with the lowest PSS score quintile, the adjusted HR for HZ was 1·00 [95% confidence interval (CI) 0·86–1·16], 1·08 (95% CI 0·92–1·26), 1·05 (95% CI 0·90–1·23) and 1·14 (95% CI 0·97–1·34) for the second to the fifth quintile, respectively. In cubic spline analyses, PSS scores < 20 were not associated with increased HR of HZ, but thereafter the HR increased linearly from 1·10 (95% CI 0·85–1·41) to 2·22 (95% CI 1·32–3·75). Conclusions: Our study indicated that high levels of psychological stress are associated with increased risk of HZ.

AB - Background: Psychological stress may reduce cellular immunity, but its role in triggering latent infections, including herpes zoster (HZ), is controversial. Objectives: To examine the association between perceived psychological stress and risk of HZ. Methods: In a linked registry-based cohort study, we followed 77 310 persons aged 40 years or older who participated in the 2010 Danish National Health Survey from 1 May 2010 until HZ diagnosis, death, emigration or 1 July 2014, whichever occurred first. We computed hazard ratios (HRs) of HZ associated with Cohen’s Perceived Stress Scale (PSS) score (range 0–40) using Cox regression with age as the timescale, adjusted for sex, immunosuppressive and selected chronic conditions, immunosuppressive drugs, and sociodemographic, lifestyle and anthropometric factors. The PSS measures chronic stress perceived by an individual in response to various demands of daily life. We modelled the PSS score using quintiles and a restricted cubic spline function. Results: The unadjusted rate of HZ varied from 5·53 to 7·20 per 1000 person-years from the lowest to the highest PSS score quintile. Compared with the lowest PSS score quintile, the adjusted HR for HZ was 1·00 [95% confidence interval (CI) 0·86–1·16], 1·08 (95% CI 0·92–1·26), 1·05 (95% CI 0·90–1·23) and 1·14 (95% CI 0·97–1·34) for the second to the fifth quintile, respectively. In cubic spline analyses, PSS scores < 20 were not associated with increased HR of HZ, but thereafter the HR increased linearly from 1·10 (95% CI 0·85–1·41) to 2·22 (95% CI 1·32–3·75). Conclusions: Our study indicated that high levels of psychological stress are associated with increased risk of HZ.

KW - DENMARK

KW - SYSTEM

KW - Humans

KW - Risk Factors

KW - Stress, Psychological/epidemiology

KW - Herpesvirus 3, Human

KW - Herpes Zoster/epidemiology

KW - Cohort Studies

KW - Incidence

UR - http://www.scopus.com/inward/record.url?scp=85105380051&partnerID=8YFLogxK

U2 - 10.1111/bjd.19832

DO - 10.1111/bjd.19832

M3 - Journal article

C2 - 33511645

AN - SCOPUS:85105380051

SN - 0007-0963

VL - 185

SP - 130

EP - 138

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 1

ER -

Perceived psychological stress and risk of herpes zoster: a nationwide population-based cohort study

Abstract

Adgang til dokumentet

Andre filer og links

Fingeraftryk

Citationsformater