Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register

Starace, Fabrizio; Mungai, Francesco; Baccari, Flavia; Galeazzi, Gian Maria

doi:10.1007/s00127-017-1468-8

Cited by 16 publications

(12 citation statements)

References 48 publications

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“…The median years of potential life lost was found to be 10 years, and it was estimated that around 14% of deaths worldwide (8 million deaths each year) are attributable to mental disorders [34]. Important overall risk factors contributing to mortality in patients with mental disorders include sociodemographic variables such as age, gender, ethnicity, unemployment and low educational attainment, physical diseases such as cancer and coronary heart disease, the specific psychiatric diagnosis and additional other psychological and behavioural problems like substance abuse and dependence; unnatural and alcohol-related causes of death seem to play a specific role for increased mortality in younger age groups of people with mental disorders [35][36][37][38].…”

Section: General Aspects Of Mortality In Patients With Mental Disordersmentioning

confidence: 99%

Psychiatric comorbidity as a risk factor for mortality in people with anorexia nervosa

Himmerich

Hotopf

Shetty

et al. 2018

Eur Arch Psychiatry Clin Neurosci

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Anorexia nervosa (AN) is found associated with increased mortality. Frequent comorbidities of AN include substance use disorders (SUD), affective disorders (AD) and personality disorders (PD). We investigated the influence of these psychiatric comorbidities on all-cause mortality with demographic and socioeconomic factors considered as confounders in the observation window between January 2007 and March 2016 for 1970 people with AN, using data from the case register of the South London and Maudsley (SLaM) NHS Foundation Trust, an almost monopoly-secondary mental healthcare service provider in southeast London. We retrieved data from its Clinical Records Interactive Search (CRIS) system as data source. Mortality was ascertained through nationwide tracing by the UK Office for National Statistics (ONS) linked to CRIS database on a monthly basis. A total of 43 people with AN died during the observation period. Standardized Mortality Ratio (SMR) with England and Wales population in 2012 as standard population for our study cohort was 5.21 (95% CI 3.77, 7.02). In univariate analyses, the comorbidity of SUD or PD was found to significantly increase the relative risks of mortality (HRs = 3.10, 95% CI 1.21, 7.92; and 2.58, 95% CI 1.23, 5.40, respectively). After adjustment for demographic and socioeconomic covariates as confounders, moderately but not significantly elevated risks were identified for SUD (adjusted HR = 1.39, 95% CI 0.53, 3.65) and PD (adjusted HR = 1.58, 95% CI 0.70, 3.56). These results suggest an elevated mortality in people with AN, which might be, at least partially, explained by the existence of the comorbidities SUD or PD.

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Section: General Aspects Of Mortality In Patients With Mental Disordersmentioning

confidence: 99%

Psychiatric comorbidity as a risk factor for mortality in people with anorexia nervosa

Himmerich

Hotopf

Shetty

et al. 2018

Eur Arch Psychiatry Clin Neurosci

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“…Stigma, described as ignorance, prejudice and discrimination (Thornicroft et al ., 2007), towards people with mental illness contributes to inequality (Phelan et al ., 2014), excess mortality (Laursen et al ., 2007; Gissler et al ., 2013; Starace et al ., 2018) and affects help-seeking behaviour (Thornicroft, 2008; Henderson et al ., 2013; Schnyder et al ., 2017). While there is evidence that mental health stigma in England has lessened since 2008, changes are still needed (Evans-Lacko et al ., 2014; Henderson et al ., 2016a, 2020; Robinson and Henderson, 2019).…”

Section: Introductionmentioning

confidence: 99%

Improvement for most, but not all: changes in newspaper coverage of mental illness from 2008 to 2019 in England

Hildersley

Potts

Anderson

et al. 2020

Epidemiol Psychiatr Sci

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Aims Time to Change, an anti-stigma programme in England, has worked to reduce stigma relating to mental illness in many facets of life. Newspaper reports are an important factor in shaping public attitudes towards mental illnesses, as well as working as a barometer reflecting public opinion. This study aims to assess the way that coverage of mental health topics and different mental illnesses has changed since 2008. Method Articles covering mental health in 18 different newspapers were retrieved using keyword searches on two randomly chosen days of each month in 2008, 2009, 2010, 2011, 2013, 2014, 2016 and 2019. A content analysis approach using a structured coding framework was used to extract information from the articles. Logistic regression models were used to estimate the change in odds of each hypothesised stigmatising or anti-stigmatising element occurring in 2019 compared to 2008 and 2016 with a Wald test to assess the overall significance of year as a predictor in the model. Further logistic regression models were used to assess the association between the diagnosis that an article was about and the odds that it was stigmatising, and whether this relationship is moderated by year of publication. Results A total of 6731 articles were analysed, and there was a significant increase in anti-stigmatising articles in 2019 compared to 2008 (OR 3.16 (2.60–3.84), p < 0.001) and 2016 (OR 1.40 (1.16–1.69), p < 0.001). Of the 5142 articles that specified a diagnosis, articles about schizophrenia were 6.37 times more likely to be stigmatising than articles about other diagnoses (OR 6.37 (3.05–13.29) p < 0.001), and there was evidence that the strength of this relationship significantly interacted with the year an article was published (p = 0.010). Articles about depression were significantly less likely to be stigmatising (OR 0.59 (0.69–0.85) p = 0.018) than those about other diagnoses, while there was no difference in coverage of eating disorders v. other diagnoses (OR 1.37 (0.67–2.80) p = 0.386); neither of these relationships showed an interaction with the year of publication. Conclusion Anti-stigma programmes should continue to work with newspapers to improve coverage of mental illness. However, interventions should consider providing specific guidance and promote awareness of rarer mental illnesses, such as schizophrenia, and evaluation should examine whether reductions in stigma extend to people with all mental illness diagnoses.

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“…Basically, although they are still working with satisfaction and motivation, mental health workers realize that the amount of resources appears to influence the quality of care and this is in line with several surveys in Italy. 26,27 It should be underlined that in item 7 of WWRR Questionnaire, which investigates this aspetc, the scores in Italy were not higher than those of other countries. 6 While non-Italian reports have sometimes denounced the exposure to violence of MHWs, 28 in our sample there are no statistically significant differences in the need for staff security between the two samples compared.…”

Section: Discussionmentioning

confidence: 95%

Respect for service users’ human rights, job satisfaction, and wellbeing are higher in mental health workers than in other health workers: A study in Italy at time of the Covid pandemic

Carta

Moro

Sancassiani

et al. 2022

Journal of Public Health Research

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Background: This study aimed to evaluate the respect for users’ rights, job satisfaction, and well-being between mental health workers (MHWs) compared to non-mental health care workers (nMHWs) from the same Italian region. Methods: The sample was recruited from community mental health and non-mental health outpatient centers in Sardinia. Participants fulfilled the WellBeing at work and respect for human-rights questionnaire (WWRR). The sample included 240 MHWs and 154 nMHWs. Results: MHWs were more satisfied with their work and workplace compared to nMHWs. MHWs had stronger beliefs that users were satisfied with the care received, and both workers and users’ human rights were respected in their workplace. MHWs reported to need more rehabilitation therapists and psychologists in their services, while nMHWs needed more nurses and professionals for users’ personal care. Italian MHWs are more satisfied with their work and workplace, and more convinced that users are satisfied with the care received and that users’ and staff human rights are respected in their workplaces, compared to nMHWs. Conclusions: The historic link between the community mental health network and other support networks in Italy and the consequent perception of proximity to the citizens of the care network may be the reason for this optimal situation of Italian MHWs.

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Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register

Abstract: Our study confirms that subjects with mental illness have higher SMR. Noteworthy, the overall higher risk of mortality was observed in the younger age group.

Cited by 16 publications

References 48 publications

Psychiatric comorbidity as a risk factor for mortality in people with anorexia nervosa

Psychiatric comorbidity as a risk factor for mortality in people with anorexia nervosa

Improvement for most, but not all: changes in newspaper coverage of mental illness from 2008 to 2019 in England

Respect for service users’ human rights, job satisfaction, and wellbeing are higher in mental health workers than in other health workers: A study in Italy at time of the Covid pandemic

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