Evidence map›Paper›PMID 27852715›Full record

ArticleBMJ open2016

Does 'existential unease' predict adult multimorbidity? Analytical cohort study on embodiment based on the Norwegian HUNT population.

Margret Olafia Tomasdottir, Johann Agust Sigurdsson, Halfdan Petursson, Anna Luise Kirkengen, Tom Ivar Lund Nilsen, Irene Hetlevik, Linn Getz

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In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  7. Pathogenesis of multimorbidity-what is known?Zeitschrift fur Gerontologie und Geriatrie · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Margret Olafia TomasdottirDepartment of Family Medicine, University of Iceland and Primary Health Care of the Capital Area, Reykjavik, Iceland.
Johann Agust SigurdssonDepartment of Family Medicine, University of Iceland and Primary Health Care of the Capital Area, Reykjavik, Iceland.
Halfdan PeturssonGeneral Practice Research Unit, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Anna Luise KirkengenGeneral Practice Research Unit, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.ORCID 0000-0001-7186-5974
Tom Ivar Lund NilsenGeneral Practice Research Unit, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Irene HetlevikGeneral Practice Research Unit, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Linn GetzGeneral Practice Research Unit, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMultimorbidity is prevalent, and knowledge regarding its aetiology is limited. The general pathogenic impact of adverse life experiences, comprising a wide-ranging typology, is well documented and coherent with the concept allostatic overload (the long-term impact of stress on human physiology) and the notion embodiment (the conversion of sociocultural and environmental influences into physiological characteristics). Less is known about the medical relevance of subtle distress or unease. The study aim was to prospectively explore the associations between existential unease (coined as a meta-term for the included items) and multimorbidity.

settingOur data are derived from an unselected Norwegian population, the Nord-Trøndelag Health Study, phases 2 (1995-1997) and 3 (2006-2008), with a mean of 11 years follow-up.

participantsThe analysis includes 20 365 individuals aged 20-59 years who participated in both phases and was classified without multimorbidity (with 0-1 disease) at baseline.

methodsFrom HUNT2, we selected 11 items indicating 'unease' in the realms of self-esteem, well-being, sense of coherence and social relationships. Poisson regressions were used to generate relative risk (RR) of developing multimorbidity, according to the respondents' ease/unease profile.

resultsA total of 6277 (30.8%) participants developed multimorbidity. They were older, more likely to be women, smokers and with lower education. 10 of the 11 'unease' items were significantly related to the development of multimorbidity. The items 'poor self-rated health' and 'feeling dissatisfied with life' exhibited the highest RR, 1.55 and 1.44, respectively (95% CI 1.44 to 1.66 and 1.21 to 1.71). The prevalence of multimorbidity increased with the number of 'unease' factors, from 26.7% for no factor to 49.2% for 6 or more.

conclusionsIn this prospective study, 'existential unease' was associated with the development of multimorbidity in a dose-response manner. The finding indicates that existential unease increases people's vulnerability to disease, concordant with current literature regarding increased allostatic load.

Indexed as

ComorbidityAdultAllostasisChronic DiseaseExerciseFemaleHumansLogistic ModelsMaleMiddle AgedNorwayPersonal SatisfactionProspective StudiesSelf ConceptAllostatic overloadEmbodimentExistential uneaseMultimorbidityStress

Identifiers

PMID27852715
PMCPMC5128847

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.