Life years lost associated with mental illness: A cohort study of beneficiaries of a South African medical insurance scheme

Ruffieux, Yann; Wettstein, Anja; Maartens, Gary; Folb, Naomi; Vieira, Cristina Mesa; Didden, Christiane; Tlali, Mpho; Williams, Chanwyn; Cornell, Morna; Schomaker, Michael; Lf, Johnson; Joska, John; Egger, Matthias; Haas, Andreas D

doi:10.1016/j.jad.2023.08.013

Cited by 2 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the growing evidence of the impact of mental disorders on physical comorbidity and premature mortality (Ruffieux et al. , 2023 ), mental healthcare in many settings remains underfunded and segmented into silos of mental and physical healthcare (O’Connor et al. , 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…This study has important implications for clinical practice. Despite the growing evidence of the impact of mental disorders on physical comorbidity and premature mortality (Ruffieux et al, 2023), mental healthcare in many settings remains underfunded and segmented into silos of mental and physical healthcare (O'Connor et al, 2023). To address the physical healthcare needs of individuals with mental illnesses, the World Health Organization, along with international experts, advocates for integrated care models that combine mental health services with physical healthcare (O'Connor et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme

Mesa-Vieira,

Didden,

Schomaker

et al. 2024

Epidemiol Psychiatr Sci

Self Cite

View full text Add to dashboard Cite

Aims Prior research, largely focused on US male veterans, indicates an increased risk of cardiovascular disease among individuals with post-traumatic stress disorder (PTSD). Data from other settings and populations are scarce. The objective of this study is to examine PTSD as a risk factor for incident major adverse cardiovascular events (MACEs) in South Africa. Methods We analysed reimbursement claims (2011–2020) of a cohort of South African medical insurance scheme beneficiaries aged 18 years or older. We calculated adjusted hazard ratios (aHRs) for associations between PTSD and MACEs using Cox proportional hazard models and calculated the effect of PTSD on MACEs using longitudinal targeted maximum likelihood estimation. Results We followed 1,009,113 beneficiaries over a median of 3.0 years (IQR 1.1–6.0). During follow-up, 12,662 (1.3%) persons were diagnosed with PTSD and 39,255 (3.9%) had a MACE. After adjustment for sex, HIV status, age, population group, substance use disorders, psychotic disorders, major depressive disorder, sleep disorders and the use of antipsychotic medication, PTSD was associated with a 16% increase in the risk of MACEs (aHR 1.16, 95% confidence interval (CI) 1.05–1.28). The risk ratio for the effect of PTSD on MACEs decreased from 1.59 (95% CI 1.49–1.68) after 1 year of follow-up to 1.14 (95% CI 1.11–1.16) after 8 years of follow-up. Conclusion Our study provides empirical support for an increased risk of MACEs in males and females with PTSD from a general population sample in South Africa. These findings highlight the importance of monitoring cardiovascular risk among individuals diagnosed with PTSD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme

Mesa-Vieira,

Didden,

Schomaker

et al. 2024

Epidemiol Psychiatr Sci

Self Cite

View full text Add to dashboard Cite

show abstract

“…Particularly little detail is reported on national differences in mortality conditional on both sex and diagnosis. Furthermore, diagnosis‐specific (excess) mortality has been reported, but rarely for the sub‐set of patients requiring and receiving SMH within this selection of disorders 6,7,9–24 …”

Section: Introductionmentioning

confidence: 99%

Life years lost for users of specialized mental healthcare

Konings,

Mierau,

Visser

et al. 2023

Acta Psychiatr Scand

View full text Add to dashboard Cite

BackgroundMental disorders are burdensome and are associated with increased mortality. Mortality has been researched for various mental disorders, especially in countries with national registries, including the Nordic countries. Yet, knowledge gaps exist around national differences, while also relatively less studies compare mortality of those seeking help for mental disorders in specialized mental healthcare (SMH) by diagnosis. Additional insight into such mortality distributions for SMH users would be beneficial for both policy and research purposes. We aim to describe and compare the mortality in a population of SMH users with the mortality of the general population. Additionally, we aim to investigate mortality differences between sexes and major diagnosis categories: anxiety, depression, schizophrenia spectrum and other psychotic disorders, and bipolar disorder.MethodsMortality and basic demographics were available for a population of N = 10,914 SMH users in the north of The Netherlands from 2010 until 2017. To estimate mortality over the adult lifespan, parametric Gompertz distributions were fitted on observed mortality using interval regression. Life years lost were computed by calculating the difference between integrals of the survival functions for the general population and the study sample, thus correcting for age. Survival for the general population was obtained from Statistics Netherlands (CBS).ResultsSMH users were estimated to lose 9.5 life years (95% CI: 9.4–9.6). Every major diagnosis category was associated with a significant loss of life years, ranging from 7.2 (95% CI: 6.4–7.9) years for anxiety patients to 11.7 (95% CI: 11.0–12.5) years for bipolar disorder patients. Significant differences in mortality were observed between male SMH users and female SMH users, with men losing relatively more life years: 11.0 (95% CI: 10.9–11.2) versus 8.3 (95% CI: 8.2–8.4) respectively. This difference was also observed between sexes within every diagnosis, although the difference was insignificant for bipolar disorder.ConclusionThere were significant differences in mortality between SMH users and the general population. Substantial differences were observed between sexes and between diagnoses. Additional attention is required, and possibly specific interventions are needed to reduce the amount of life years lost by SMH users.

show abstract

Life years lost associated with mental illness: A cohort study of beneficiaries of a South African medical insurance scheme

Cited by 2 publications

References 32 publications

Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme

Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme

Life years lost for users of specialized mental healthcare

Contact Info

Product

Resources

About