Mortality in individuals who have had psychiatric treatment

Kisely, Steve; Smith, Mark; Lawrence, David; Maaten, Sarah

doi:10.1192/bjp.187.6.552

Cited by 94 publications

(87 citation statements)

References 25 publications

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“…A number of studies have previously found an association between PD and raised mortality [12][13][14][15][16]. However, to our knowledge, our study is the first to comprehensively examine the life expectancy of secondary care service users with PD.…”

Section: Main Findingsmentioning

confidence: 91%

“…It is one of the hardest psychiatric conditions to treat and has a considerable economic impact on general medical and mental health services. People with personality disorder (PD) are known to be at particularly high risk of increased mortality as a result of both natural and unnatural causes [12][13][14][15][16]. However, no study has comprehensively examined life expectancy at birth of the full range of secondary care service users with PD.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Life expectancy at birth and all-cause mortality among people with personality disorder

Fok

Hayes

Chang

et al. 2012

Journal of Psychosomatic Research

204

150

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Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in the Journal of Psychosomatic Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be re ected in this document. Changes may have been made to this work since it was submitted for publication. Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. ABSTRACT ObjectiveIt is well established that serious mental illness is associated with raised mortality, yet few studies have looked at the life expectancy of people with personality disorder (PD). This study aims to examine the life expectancy and relative mortality in people with PD within secondary mental health care. MethodsWe set out to examine this using a large psychiatric case register in southeast London, UK.Mortality was obtained through national mortality tracing procedures. In a cohort of patients with a primary diagnosis of PD (n=1836), standardized mortality ratios (SMRs) and life expectancies at birth were calculated, using general population mortality statistics as the comparator. ResultsLife expectancy at birth was 63.3 years for women and 59.1 years for men with PD -18.7 years and 17.7 years shorter than females and males respectively in the general population in England and Wales. The SMR was 4.2 (95% CI: 3.03 -5.64) overall; 5.0 (95% CI: 3.15 -7.45) for females and 3.5 (95% CI: 2.17 -5.47) for males. The highest SMRs were found in the younger age groups for both genders. ConclusionPeople with PD using mental health services have a substantially reduced life expectancy, highlighting the significant public health burden of the disorder.

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Section: Main Findingsmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Life expectancy at birth and all-cause mortality among people with personality disorder

Fok

Hayes

Chang

et al. 2012

Journal of Psychosomatic Research

204

150

View full text Add to dashboard Cite

show abstract

“…El tratamiento antipsicótico siempre se ha asociado a estas alteraciones cardiometabólicas, sin embargo, la evidencia muestra que pacientes que nunca han recibido tratamiento también presentan estas patologías concomitantes 4 , además que muchas de ellas se encuentran desde el primer episodio psicótico, por ende, se postula que la EQZ per se estaría relacionada con esta alteración 5,6 .…”

Section: The Life Expectancy Of Patients With Schizophrenia (Sch) Is unclassified

Esquizofrenia y su asociación con enfermedades médicas crónicas

et al. 2017

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The life expectancy of patients with schizophrenia (SCH) is 11 to 20 years less than the general population. There is an association between SCH and various diseases and chronic conditions, highlighting the cardio-metabolic diseases. This association has been attributed to the use of antipsychoticsSe caracteriza por síntomas positivos (alucinaciones, delirio, síntomas catatónicos y discurso desorganizado), negativos (aplanamiento afectivo y anhedonia) y disfunciones cognitivas (alteración de atención, memoria y funciones ejecutivas) 1 . Además, hay perturbaciones fisiológicas severas que aumentan la gravedad de la EQZ, de hecho, se evidencian alteraciones endocrinológicas, del sueño, cardiovasculares y metabólicas con alteración del peso, regulación de glicemia, metabolismo lipídico y presión arterial, cuyos mecanismos no se conocen del todo 2 .La expectativa de vida de los pacientes con EQZ es entre 11 y 20 años menor que la población general y la mortalidad cardiovascular ha aumentado en este grupo de pacientes, en contraste a la población general 3 .El tratamiento antipsicótico siempre se ha asociado a estas alteraciones cardiometabólicas, sin embargo, la evidencia muestra que pacientes que nunca han recibido tratamiento también presentan estas patologías concomitantes 4 , además que muchas de ellas se encuentran desde el primer episodio psicótico, por ende, se postula que la EQZ per se estaría relacionada con esta alteración 5,6 .Este trabajo pretende actualizar los conocimientos con respecto a comorbilidades médicas crónicas asociadas a la EQZ y ayudar así a optimizar el manejo clínico de estos pacientes.

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“…[1][2][3][4][5] Higher mortality is frequently associated with 'lifestyle choices', such as smoking, poor diet, physical inactivity, substance misuse and abuse and unsafe sexual practices. 3,6 However, even after adjusting for behavioural risk factors, mortality remains high for this population.…”

Section: Introductionmentioning

confidence: 99%

General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial

Cameron¹,

Nazar²,

Ehrlich³

et al. 2017

Aust. Health Review

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Objective. The aim of the present study was to assess the effects of a community intervention aimed at general practitioners (GPs) by comparing Medicare claims data from patients with severe mental illness (SMI) of GPs exposed to the intervention and controls that were not.Methods. A comparison was made of primary care consultation and pathology data of people with SMI from intervention and control areas. Negative binomial regression models were used to compare the frequency and length of GP consultations, as well as the number and type of pathology examinations.Results. Records of 103 people from intervention area and 98 controls were obtained. Intervention and control areas were not different at baseline in terms of age and claims data, but females had higher consultation rates. After adjusting for gender, people from intervention areas had more GP consultations, especially long consultations (adjusted incidence rate ratio 1.56; 95% confidence interval 1.28-1.91). They also had more pathology screening for chronic diseases, in accordance with implemented guideline recommendations. These benefits persisted after the end of the intervention.Conclusion. These findings suggest that the ACTIVATE program aimed at training GPs to screen and better manage chronic diseases in adults with SMI had a positive effect up to 6 months after the trial, with demonstrated desired changes in medical management practices by GPs in the intervention area during that time.What is known about the topic? People with an SMI have higher mortality and poorer physical health than the general population. What does this paper add? The community intervention had a significant and sustained effect, with demonstrated desired changes in screening and medical management by GPs for adults with SMI in the intervention area. What are the implications for practitioners? GPs are ideally placed to assist in the prevention and better management of health conditions, thereby reducing avoidable illness and deaths in vulnerable populations, such as adults with SMI. HEALTH SERVICE RESEARCHOngoing professional training and dissemination of clinical guidelines are critical for raising awareness about the physical and oral health care needs of people with SMI.Additional keyword: health services research.

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Mortality in individuals who have had psychiatric treatment

Abstract: Mortality risk is increased in all psychiatric patients, not just those who have received in-patient treatment.

Cited by 94 publications

References 25 publications

Life expectancy at birth and all-cause mortality among people with personality disorder

Life expectancy at birth and all-cause mortality among people with personality disorder

Esquizofrenia y su asociación con enfermedades médicas crónicas

General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial

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