The Association of Perceived Mental Stress, Sense of Purpose in Life, and Negative Life Events With the Risk of Incident Herpes Zoster and Postherpetic Neuralgia: The SHEZ Study

Abstract

This population-based prospective study examined the relationships of perceived mental stress, sense of purpose in life, and negative life events to the incidence of herpes zoster (HZ) and postherpetic neuralgia (PHN). The data were collected from 12,359 participants (aged ≥50 years old in Shozu County, Kagawa Prefecture, Japan) who answered a self-completed health questionnaire. During a 3-year follow-up between December 2008 and November 2012, HZ and PHN were diagnosed in 400 and 79 subjects, respectively. We used Cox regression analysis to estimate hazard ratios of incident HZ and PHN according to psychosocial factors, adjusting for age, sex, history of HZ, cancer, and diabetes, smoking and drinking habits and the period from the onset to treatment. Men who felt their mental stress very high versus low had twice the risk of incident HZ. The risk of incident HZ was approximately 60% lower among men and women confirming very high versus low sense of purpose in life. Women who experienced negative life events, especially changes in their work and living environments and human relations, had two to three fold higher risk of incident PHN. Psychosocial factors may contribute to the development of HZ and PHN in the general population.