ARE STRESSFUL LIFE EVENTS RISK-FACTORS FOR HERPES-ZOSTER

To determine if psychologically stressful life events are risk factors for herpes zoster, we conducted a case‐control study of zoster and self‐reported recent negative life events and major changes in spousal relationships. The subjects were 101 healthy community‐dwelling cases of zoster and 101 healthy controls matched for age, sex, and race and generated by random digit dialing. The Geriatric Scale of Recent Life Events was administered to case and control subjects, and additional questions were asked regarding the perception of the life event. The results showed that case subjects experienced negative life events significantly more often than subjects in the control groups in the 2 months before zoster onset by analysis of discordant pairs (26 versus 10, odds ratio 2.60, 95% confidence interval [CI] 1.13, 6.27, P = .012), 3 months before (29 versus 11, odds ratio 2.64, 95% CI 1.20, 6.04, P = .007), or 6 months before (35 versus 16, odds ratio 2.00, 95% CI 1.04, 3.93, P = .012). The mean number of total life events was significantly higher in cases at 6 months before zoster (case x̄ = 2.64, control x̄ =1.82, P = .008), but there were no signficant differences at 2, 3, or 12 months before. There were no significant differences between case subjects and control subjects for spousal events, or any given single life event. In conclusion, we found that whereas patients with herpes zoster experienced the same kinds of life events in the year preceding the illness as did control subjects, recent events perceived as stressful were significantly more common among patients with zoster. These results provide supportive evidence that stressful life events may be risk factors for the reactivation of varicella‐zoster virus. © 1990 The American Geriatrics Society