Social withdrawal and suicide risk: A descriptive study

Abstract

Introduction Type A behaviour pattern (TABP) is defined as the combination of competitive need for achievement, sense of time urgency, aggressiveness, and hostility. Studies raised evidence for an association between TABP and cardiovascular disease. Recent studies on its association with mortality showed contradicting results and used different methods to measure TABP. Objectives/aims Investigating the association between TABP and all-cause, CVD, and all-cancer mortality. Methods We used data of the MONICA and the NRP1A studies that were linked with the Swiss National Cohort (SNC) (n = 7997). Essentially, the SNC is an anonymous record linkage of census, migration and mortality data. TABP was measured by the Bortner Scale. To determine the all-cause, CVD, and cancer mortality risk a Cox regression was performed. Following Edwards et al. (1990), we analysed the Bortner Scale in two different ways: all items and its two dimensions (speed and competitiveness) separately. Results We found a significant association of the Bortner Scale with all-cause mortality in women (adjusted for sociodemographic factors HR 1.02, 95% CI 1.00-1.03, additionally adjusted for lifestyle factors-smoking, alcohol intake, physical activity, BMI category-1.01, 1.00-1.03). The subscale of competitiveness was associated with all-cause and CVD mortality in women. Interestingly, stratifying for lifestyle variables revealed that the association was only present in those having a healthy lifestyle, e.g. nonsmoking or non-hazardous alcohol intake. Conclusions The Bortner Scale and its subscale of competitiveness were associated with mortality in women. In those having great health awareness, this might offer potential for further reduction of mortality risk. Disclosure of interest The authors have not supplied their declaration of competing interest.