Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Original Article
Sex-specific Relationship Between Stress Coping Strategies and All-cause Mortality: Japan Multi-Institutional Collaborative Cohort Study
Mako NagayoshiKenji TakeuchiYudai TamadaYasufumi KatoYoko KuboRieko OkadaTakashi TamuraAsahi HishidaJun OtonariHiroaki IkezakiYuichiro NishidaChisato ShimanoeYuriko N. KoyanagiKeitaro MatsuoHaruo MikamiMiho KusakabeDaisaku NishimotoKeiichi ShibuyaSadao SuzukiTakeshi NishiyamaEtsuko OzakiIsao WatanabeKiyonori KurikiNaoyuki TakashimaAya KadotaKokichi ArisawaSakurako Katsuura-KamanoKenji Wakai
ジャーナル オープンアクセス

2023 年 33 巻 5 号 p. 236-245


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.

© 2021 Mako Nagayoshi et al.

This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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