Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T17:46:34.062Z Has data issue: false hasContentIssue false
  • English
  • Français

Contributions of specific causes of death to lost life expectancy in severe mental illness

Published online by Cambridge University Press:  23 March 2020

N. Jayatilleke ,
R.D. Hayes ,
R. Dutta ,
H. Shetty ,
M. Hotopf ,
C.-K. Chang  and
R. Stewart
N. Jayatilleke
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
R.D. Hayes
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
R. Dutta
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
H. Shetty
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
M. Hotopf
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
C.-K. Chang*
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
R. Stewart
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
*
*Corresponding author. Tel.: +44 2032 288 590; fax: +44 2032 288 551. E-mail address:[email protected] (C.-K. Chang).
Get access

Abstract

The life expectancy gap between people with severe mental illness (SMI) and the general population persists and may even be widening. This study aimed to estimate contributions of specific causes of death to the gap. Age of death and primary cause of death were used to estimate life expectancy at birth for people with SMI from a large mental healthcare case register during 2007–2012. Using data for England and Wales in 2010, death rates in the SMI cohort for each primary cause of death category were replaced with gender- and age-specific norms for that cause. Life expectancy in SMI was then re-calculated and, thus, the contribution of that specific cause of death estimated. Natural causes accounted for 79.2% of lost life-years in women with SMI and 78.6% in men. Deaths from circulatory disorders accounted for more life-years lost in women than men (22.0% versus 17.4%, respectively), as did deaths from cancer (8.1% versus 0%), but the contribution from respiratory disorders was lower in women than men (13.7% versus 16.5%). For women, cancer contributed more in those with non-affective than affective disorders, while suicide, respiratory and digestive disorders contributed more in those with affective disorders. In men, respiratory disorders contributed more in non-affective disorders. Other contributions were similar between gender and affective/non-affective groups. Loss of life expectancy in people with SMI is accounted for by a broad range of causes of death, varying by gender and diagnosis. Interventions focused on multiple rather than individual causes of death should be prioritised accordingly.

Keywords

Severe mental illnessSchizophreniaBipolar disorderLife expectancyCause of deathPhysical illness
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 109 - 115
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Joint last authors.

References

Chesney, EGoodwin, GMFazel, SRisks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 2014;13: 153–160.CrossRefGoogle ScholarPubMed
Laursen, TMMunk-Olsen, TNordentoft, MMortensen, PBIncreased mortality among patients admitted with major psychiatric disorders: a register-based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia. J Clin Psychiatry 2007;68: 899–907.CrossRefGoogle Scholar
Chang, C-KHayes, RDPerera, GBroadbent, MTMFernandes, ACLee, WEet al.Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS One 2011;6(5):e19590.CrossRefGoogle Scholar
Hoang, UStewart, RGoldacre, MJMortality after hospital discharge for people with schizophrenia or bipolar disorder: retrospective study of linked English hospital episode statistics, 1999–2006. Br Med J 2011;343:d5422.CrossRefGoogle ScholarPubMed
Das-Munshi, JAshworth, MDewey, MEGaughran, FHull, SMorgan, Cet al.Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross-sectional analysis of 588,408 records from the UK. Diabet Med 2016;2016. http://dx.doi.org/10.1111/dme.13298 [Epub ahead of print].CrossRefGoogle Scholar
Barnett, KMercer, SWNorbury, MWatt, GWyke, SGuthrie, BEpidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012;380(9836):37–43.CrossRefGoogle ScholarPubMed
Scott, DHappell, BThe high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs 2011;32(9):589–597.CrossRefGoogle ScholarPubMed
Perera, GBroadbent, MCallard, FChang, C-KDowns, JDutta, Ret al.Cohort profile of the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register: current status and recent enhancement of an Electronic Mental Health Record-derived data resource. BMJ Open 2016;6.CrossRefGoogle Scholar
Fernandes, ACCloete, DBroadbent, MTMHayes, RDChang, C-KJackson, RGet al.Development and evaluation of a de-identification procedure for a case register sourced from mental health electronic records. BMC Med Inform Decis Mak 2013;13(1):71CrossRefGoogle ScholarPubMed
Taylor, CLStewart, ROgden, JBroadbent, MPasupathy, DHoward, LMThe characteristics and health needs of pregnant women with schizophrenia compared with bipolar disorder and affective psychoses. BMC Psychiatry 2015;15:88.CrossRefGoogle ScholarPubMed
Lopez-Morinigo, JDFernandes, ACChang, CKHayes, RDBroadbent, MStewart, Ret al.Suicide completion in secondary mental healthcare: a comparison study between schizophrenia spectrum disorders and all other diagnoses. BMC Psychiatry 2014;14:213.CrossRefGoogle ScholarPubMed
Office for National, Statistics Causes of Death, [Internet]. [cited 2015 Aug, 1]; 2016 Available from: http://www.ons.gov.uk/ons/taxonomy/search/index.html?nscl=Causes+of+Death&nscl-orig=Causes+of+Death&content-type=Dataset&content-type=Reference+table&sortDirection=DESCENDING&sortBy=pubdate.Google Scholar
Chiang, CLThe Life Table and Its Applications, Malabar, FL: Robert E. Krieger Publishing Company; 1984.Google Scholar
Office for National Statistics Period- and cohort-life expectancy tables [Internet]. [cited 2016 Aug 1]; 2016 Available from: http://webarchive.nationalarchives.gov.uk/20160105160709/http://www.ons.gov.uk/ons/rel/lifetables/period-and-cohort-lifeexpectancy-tables/2010-based/new-component.xls.Google Scholar
Office for National Statistics Statistical bulletin: deaths registered in England and Wales 2012 [Internet]; 2013 Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregistrationsummarytables/2013-07-10#summary.Google Scholar
Lawrence, DHancock, KJKisely, SThe gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population-based registers. BMJ 2013;346:f2539.CrossRefGoogle ScholarPubMed
Kessing, LVVradi, EMcIntyre, RSAndersen, PKCauses of decreased life expectancy over the life span in bipolar disorder. J Affect Disord 2015;180: 142–147.CrossRefGoogle ScholarPubMed
Palmer, BAPankratz, VSBostwick, JMThe lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry 2005;62: 247–253.CrossRefGoogle ScholarPubMed
Nordentoft, MWahlbeck, KHällgren, JWestman, JOsby, UAlinaghizadeh, Het al.Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PLoS One 2013;8:e55176.CrossRefGoogle ScholarPubMed
Chang, C-KHayes, RDBroadbent, MHotopf, MDavies, EMøller, HSRA Cohort study on mental disorders, stage of cancer at diagnosis and subsequent survival. BMJ Open 2014;4:e004295 [doi:10.1136/bmjopen-2013-004295].CrossRefGoogle ScholarPubMed
Partti, KVasankari, TKanervisto, MPerala, JSaarni, SIJousilahti, Pet al.Lung function and respiratory diseases in people with psychosis: population-based study. Br J Psychiatry 2015;207: 37–45.CrossRefGoogle ScholarPubMed
De Leon, JDFA meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res 2005;76(2–3):135–157.CrossRefGoogle ScholarPubMed
Lawrence, DMitrou, FZubrick, SRSmoking and mental illness: results from population surveys in Australia and the United States. BMC Public Health 2009;9:285.CrossRefGoogle ScholarPubMed
Osborn, DPJNazareth, IKing, MBPhysical activity, dietary habits and Coronary Heart Disease risk factor knowledge amongst people with severe mental illness: a cross-sectional comparative study in primary care. Soc Psychiatry Psychiatr Epidemiol 2007;42: 787–793.CrossRefGoogle ScholarPubMed
Kendrick, TCardiovascular and respiratory risk factors and symptoms among general practice patients with long-term mental illness. Br J Psychiatry 1996;169: 733–739.CrossRefGoogle ScholarPubMed
Davidson, SJudd, FJolley, DHocking, BThompson, SHBCardiovascular risk factors for people with mental illness. Aust N Z J Psychiatry 2001;35: 196–202.CrossRefGoogle ScholarPubMed
Lawrence, DHancock, KJKisely, SThe gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population-based registers. Br Med J 2013;349:f2539.CrossRefGoogle Scholar
Wu, S-IChen, S-CJuang, JJMFang, C-KLiu, S-ISun, F-Jet al.Association between schizophrenia and bipolar disorder with diagnostic procedures, revascularization, and inpatient mortality following acute myocardial infarction. Psychosom Med 2013;75: 52–59.CrossRefGoogle Scholar
Muntaner, CEaton, WWMiech, RO'Campo, PSocio-economic position and major mental disorders. Epidemiol Rev 2004;26: 53–62.CrossRefGoogle Scholar
Lawrence, DKisely, SInequalities in healthcare provision for people with severe mental illness. J Psychopharmacol 2010;24(4 Suppl.):61–68.CrossRefGoogle ScholarPubMed
Lawrence, DJablensky, AVHolman, Pinder, TJMortality in Western Australian psychiatric patients. Soc Psychiatry Psychiatr Epidemiol 2000;35: 341–347.CrossRefGoogle ScholarPubMed
NICE Psychosis and schizophrenia in adults: prevention and management 2014 [cited 2017 Jan 18]. Available from: https://www.nice.org.uk/guidance/cG178/ifp/chapter/Assessment.Google Scholar
Thornicroft, GPremature death among people with mental illness. BMJ 2013;346:f2969.CrossRefGoogle ScholarPubMed
Link, BGTehranifar, PPhelan, JCSocial conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav 2010;51:S28–S40.Google Scholar
Submit a response

Comments

No Comments have been published for this article.