Mortality in Mental Disorders and Global Disease Burden Implications: A Systematic Review and Meta-analysis
TLDR
Estimates suggest that mental disorders rank among the most substantial causes of death worldwide, and efforts to quantify and address the global burden of illness need to better consider the role of mental disorders in preventable mortality.Abstract:
Importance Despite the potential importance of understanding excess mortality among people with mental disorders, no comprehensive meta-analyses have been conducted quantifying mortality across mental disorders. Objective To conduct a systematic review and meta-analysis of mortality among people with mental disorders and examine differences in mortality risks by type of death, diagnosis, and study characteristics. Data sources We searched EMBASE, MEDLINE, PsychINFO, and Web of Science from inception through May 7, 2014, including references of eligible articles. Our search strategy included terms for mental disorders (eg, mental disorders, serious mental illness, and severe mental illness), specific diagnoses (eg, schizophrenia, depression, anxiety, and bipolar disorder), and mortality. We also used Google Scholar to identify articles that cited eligible articles. Study selection English-language cohort studies that reported a mortality estimate of mental disorders compared with a general population or controls from the same study setting without mental illness were included. Two reviewers independently reviewed the titles, abstracts, and articles. Of 2481 studies identified, 203 articles met the eligibility criteria and represented 29 countries in 6 continents. Data extraction and synthesis One reviewer conducted a full abstraction of all data, and 2 reviewers verified accuracy. Main outcomes and measures Mortality estimates (eg, standardized mortality ratios, relative risks, hazard ratios, odds ratios, and years of potential life lost) comparing people with mental disorders and the general population or people without mental disorders. We used random-effects meta-analysis models to pool mortality ratios for all, natural, and unnatural causes of death. We also examined years of potential life lost and estimated the population attributable risk of mortality due to mental disorders. Results For all-cause mortality, the pooled relative risk of mortality among those with mental disorders (from 148 studies) was 2.22 (95% CI, 2.12-2.33). Of these, 135 studies revealed that mortality was significantly higher among people with mental disorders than among the comparison population. A total of 67.3% of deaths among people with mental disorders were due to natural causes, 17.5% to unnatural causes, and the remainder to other or unknown causes. The median years of potential life lost was 10 years (n = 24 studies). We estimate that 14.3% of deaths worldwide, or approximately 8 million deaths each year, are attributable to mental disorders. Conclusions and relevance These estimates suggest that mental disorders rank among the most substantial causes of death worldwide. Efforts to quantify and address the global burden of illness need to better consider the role of mental disorders in preventable mortality.read more
Citations
More filters
Journal ArticleDOI
Physical and mental health burden in cases of bipolar disorder classified as current, former, or non-tobacco smokers
Romain Icick,Sébastien Gard,M. Barde,M. Carminati,A. Desage,Sébastien Guillaume,Jan Scott,Frank Bellivier +7 more
TL;DR: The increased risk of physical and mental health burden in CS and FS compared to NS represents avoidable morbidity in BD and offers support to the argument that individuals with BD should be routinely offered support to prevent or stop tobacco smoking.
Journal ArticleDOI
Evaluating the effectiveness of a healthy lifestyle clinician in addressing the chronic disease risk behaviours of community mental health clients: study protocol for a randomised controlled trial
Caitlin Fehily,Kate Bartlem,John Wiggers,Paula Wye,Paula Wye,Richard Clancy,Richard Clancy,David J. Castle,Sonia Wutzke,Chris Rissel,Andrew Wilson,Paul McCombie,Fionna Murphy,Jenny Bowman +13 more
TL;DR: A randomised controlled trial that aims to assess the effectiveness of allocating a clinician within a community mental health service to the specific role of providing assessment, advice and referral for clients’ chronic disease risk behaviours.
Journal ArticleDOI
Chinese Health Improvement Profile for people with severe mental illness: A cluster‐randomized, controlled trial
Daniel Bressington,Wai Tong Chien,Jolene Mui,Kar Kei Claire Lam,Ziyad Mahfoud,Jacquie White,Richard Gray +6 more
TL;DR: The findings suggest that it is feasible to conduct a full-scale RCT of the CHIP, an intervention that can be used within routine CPN practice, and could result in small-modest improvements in the physical well-being of people with SMI.
Journal ArticleDOI
From the Editor's desk: matters of the heart and mind.
TL;DR: Papers in this month’s issue suggest that the treatment and aetiology of vascular and psychiatric disorders are closely linked, and vascular disease might lead to neuropsychiatric symptoms including depression, movement disorders and dementia, and show the importance of psychoeducation to reduce carer burden and psychological distress.
Book ChapterDOI
The Role of Neurotrophic Factors in Pathophysiology of Major Depressive Disorder.
TL;DR: According to the neurotrophic hypothesis of major depressive disorder (MDD), impairment in growth factor signaling might be associated with the pathology of this illness as mentioned in this paper, and the current literature on the involvement of neurotrophic factors and related signaling pathways in the pathophysiology of MDD is summarized in this paper.
References
More filters
Journal ArticleDOI
Measuring inconsistency in meta-analyses
TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Journal ArticleDOI
Meta-Analysis in Clinical Trials*
TL;DR: This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Journal ArticleDOI
Meta-analysis of observational studies in epidemiology - A proposal for reporting
Donna F. Stroup,Jesse A. Berlin,Sally C. Morton,Ingram Olkin,G. D. Williamson,Drummond Rennie,Drummond Rennie,David Moher,Betsy Jane Becker,Theresa Ann Sipe,Stephen B. Thacker +10 more
TL;DR: A checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion should improve the usefulness ofMeta-an analyses for authors, reviewers, editors, readers, and decision makers.
Book
Practical Meta-Analysis
Mark W. Lipsey,David B. Wilson +1 more
TL;DR: This paper presents a meta-analysis procedure called “Meta-Analysis Interpretation for Meta-Analysis Selecting, Computing and Coding the Effect Size Statistic and its applications to Data Management Analysis Issues and Strategies.
Related Papers (5)
Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.
Harvey Whiteford,Harvey Whiteford,Louisa Degenhardt,Louisa Degenhardt,Juergen Rehm,Juergen Rehm,Amanda J Baxter,Amanda J Baxter,Alize J. Ferrari,Alize J. Ferrari,Holly E. Erskine,Holly E. Erskine,Fiona J Charlson,Fiona J Charlson,Rosana E. Norman,Rosana E. Norman,Abraham D. Flaxman,Nicole E. Johns,Roy Burstein,Christopher J L Murray,Theo Vos +20 more