Lifetime experience of multiple common mental disorders and 19-year mortality: results from a Canadian population-based cohort

Abstract

Aims: To examine the impact of multiple psychiatric disorders over the lifetime on risk of mortality in the general population. Methods: Data came from a random community-based sample of 1,397 adults in Atlantic Canada, recruited in 1992. Major depression, dysthymia, panic disorder, generalized anxiety disorder, and alcohol use disorders were assessed using the Diagnostic Interview Schedule (DIS). Vital status of participants through 2011 was determined using probabilistic linkages to the Canadian Mortality Database. Cox proportional hazard models with age at study entry as the time scale were used to investigate the relationship between DIS diagnoses and mortality, adjusted for participant education, smoking, and obesity at baseline. Results: Results suggested that mood and anxiety disorders rarely presented in isolation – the majority of participants experienced multiple psychiatric disorders over the lifetime. Elevated risk of death was found among men with both major depression and dysthymia (HR:2.56; 95%CI:1.12,5.89), depression and alcohol use disorders (HR:2.45; 95%CI:1.18,5.10), and among men and women who experienced both panic disorder and alcohol use disorders (HR:3.80; 95%CI:1.19,12.16). Conclusion: The experience of multiple mental disorders over the lifetime is extremely common, and associated with increased risk of mortality, most notably among men. Clinicians should be aware of the importance of considering contemporaneous symptoms of multiple psychiatric conditions.

Mental disorders and total mortality after 20 years in an adult general population sample

“…With respect to alcohol dependence, our data are in line with well-established findings of increased total mortality and shortened life expectancy compared to the age-equivalent general population [20,21]. Our data confirm those of four mortality follow-up studies in part [9,12,22,23]. In the Finnish study, those with current alcohol use disorder had an increased HR after 8 years [12].…”

“…In the Finnish study, 22.3% of those with current dysthymia had been deceased after 11 years in comparison to 12.8% of those with current major depressive disorder at baseline [24]. Our data do not confirm that major depression was also related to premature death [12] and are in contrast to those from a community sample of 1,397 adult persons in Canada [22]. In that study, the Diagnostic Interview Schedule was applied in 1992, and in 2011, vital status data were gathered.…”

Associations of common mental disorder with alcohol use in the adult general population: a systematic review and meta‐analysis

“…Among the general population, research has found associations between CMD with binge drinking [ 8 , 9 , 10 ] and AUD [ 11 ]. Research has also shown that those with co‐occurring panic disorder and AUD or depression and AUD are at an increased risk of mortality compared to those without such disorders [ 12 , 13 ]. Elsewhere, a narrative review found evidence to suggest that anxiety and depressive episodes are related to binge drinking which can subsequently lead to injury [ 14 ].…”

Do patients with mental health and substance use conditions experience discrimination and diagnostic overshadowing in primary care in Aotearoa New Zealand? Results from a national online survey

“…[1][2][3] Those with multiple MHSUC diagnoses, especially a psychiatric and substance use disorder (dual diagnosis), have an even greater risk of premature mortality. [4][5][6] International evidence suggests that reduced quality of care is a modifiable cause of these poor physical health outcomes. 7,8 Several aspects of quality of care may contribute to unequal health outcomes in people with MHSUC.…”