Positive psychological well-being and mortality: A quantitative review of prospective observational studies

Objective: To review systematically prospective, observational, cohort studies of the association between positive well-being and mortality using meta-analytic methods. Recent years have witnessed increased interest in the relationship between positive psychological well-being and physical health. Methods: We searched general bibliographic databases: Medline, PsycINFO, Web of Science, and PubMed up to January 2008. Two reviewers independently extracted data on Study characteristics, quality, and estimates of associations. Results: There were 35 studies (26 articles) investigating mortality in initially healthy Populations and 35 studies (28 articles) of disease populations. The meta-analyses showed that positive psychological well-being was associated with reduced mortality in both the healthy population (combined hazard ratio (HR) = 0.82; 95% Confidence Interval (Cl) = 0.76-0.89; p < .001) and the disease Population (combined FIR = 0.98; CI = 0.95-1.00; p = .030) studies. There were indications Of publication bias in this literature, although the fail-safe numbers were 2444 and 1397 for healthy and disease Population studies,, respectively. Intriguingly, meta-analysis of studies that controlled for negative affect showed that the protective effects of positive psychological well-being were independent of negative affect. Both positive affect (e.g., emotional well-being, positive mood, joy, happiness, vigor, energy) and positive trait-like dispositions (e.g., life satisfaction, hopefulness, optimism, sense of humor) were associated with reduced mortality in healthy population Studies. Positive psychological well-being was significantly associated with reduced cardiovascular mortality in healthy population studies, and with reduced death rates in patients with renal failure and with human immunodeficiency virus-infection. Conclusions: The Current review suggests that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations.