Psychological consequences of screening for cardiovascular risk factors in an un-selected
general population: results from the Inter99 randomised intervention study
Sammanfattning
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 are only based on self-reports from participants. Aim: To investigate if risk
factor screening in healthy adults leads to mental distress in the study population, independent of
participation. Methods: The Inter99 study (1999 - 2006) was a randomised intervention in the general
population, aiming to prevent IHD by a healthier lifestyle. We included the whole study population,
independent of participation (n = 60,915). We merged data with information on the use of psychotropic
medication and/or hospitalisation due to psychiatric diagnoses, as retrieved from national registers
in Denmark, 4 years before and 5 years after the study began. We conducted analyses using
generalised estimating equations. Results: There was no significant difference between the
intervention and control groups in their use of antipsychotics, hypnotics/sedatives, antidepressants
or anxiolytics. As regards admission to the hospital with mental disorders, no significant difference
was seen. These findings were true based on a yearly basis, and when investigating both short-term
and a long-term effects of the intervention. There was no interaction with socioeconomic status. Of the
918 persons with a psychiatric diagnosis before the study start, 303 (33%) were re-admitted in the
intervention period. Pre-screening of psychological status did not influence the psychological impact
of screening. Conclusions: 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 Inter99 study population (not only study
participants).