Programme no. 238-OP
Psychological consequences of screening for cardiovascular risk
factors in an un-selected general population: Results from the Inter99
randomised intervention study
Thomas Løkkegaard*1, Rikke Kart Jacobsen 2, Jens Henrik Badsberg3, John Sahl Andersen4, Torben Jørgensen5, Charlotta Pisinger6
1Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 2Research Centre for Prevention and Health,Glostrup University Hospital,Glostrup,Denmark, 3Research Centre for Prevention and Health,Glostrup University Hospital,Glostrup,Denmark, 4Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 5Research Centre for Prevention and Health,Glostrup University Hospital,Glostrup,Denmark, 6Research Centre for Prevention and Health,Glostrup University Hospital,Glostrup,Denmark
* = Presenting author
Objectives: To investigate if risk factor screening in healthy adults leads to mental distress in the study population, independent of participation.
Background: Concerns that general health checks, including screening for risk factors to ischemic heart disease (IHD), have negative psychological consequences seem widely unfounded. However, previous studies were based on self-reports from participants only.
Results: There was no significant difference between intervention and control group in use of antipsychotics, hypnotics/sedatives, antidepressants or anxiolytics. As regards admission to hospital with mental disorders no significant difference was seen. These findings were both on a yearly basis, and when investigating a short-term and a long term effect of the intervention. There was no interaction with socioeconomic status. Of the 918 persons with a psychiatric diagnosis before study start 303 (33%) were re-admitted in the intervention period. Pre-screen psychological status did not influence the psychological impact of screening.
Material/Methods: The Inter99 study (1999-2006) is a randomised intervention in the general population, aimed to prevent IHD by healthier lifestyle. We included the whole study population, independent of participation (n=60,915). We merged data with information on use of psychotropic medication and/or hospitalisation due to psychiatric diagnosis, retrieved from national registers, four years before and five years after study start. Analyses were conducted by generalized estimating equations.
Conclusion: This large randomised intervention study supports that screening for risk factors to IHD does not increase mental distress, not even in the mentally or socioeconomically most vulnerable persons. This study included the whole study population, not only the participants.
Points for discussion:
1. How do we measure mental distress?
2. Does screening affect psychological well-being?
3. Does qualitative and quantitative research show the same results?
4. What do we know about mental health and socio-economic status of non-attenders in screening trials?