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
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Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas
Nancy H. Liu,Nancy H. Liu,Gail L. Daumit,Tarun Dua,Ralph Aquila,Fiona J Charlson,Pim Cuijpers,Benjamin G. Druss,Kenn Dudek,Melvyn Freeman,Chiyo Fujii,Wolfgang Gaebel,Ulrich Hegerl,Itzhak Levav,Thomas Munk Laursen,Hong Ma,Mario Maj,María Elena Medina-Mora,Merete Nordentoft,Dorairaj Prabhakaran,Karen Pratt,Martin Prince,Thara Rangaswamy,David Shiers,Ezra Susser,Graham Thornicroft,Kristian Wahlbeck,Abe Fekadu Wassie,Harvey Whiteford,Shekhar Saxena +29 more
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Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC):
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Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression: A Randomized Clinical Trial
Ella Daly,Jaskaran Singh,Maggie Fedgchin,Kimberly Cooper,Pilar Lim,Richard C. Shelton,Michael E. Thase,Andrew Winokur,Luc Van Nueten,Husseini K. Manji,Wayne C. Drevets +10 more
TL;DR: In this first clinical study to date of intranasal esketamine for TRD, antidepressant effect was rapid in onset and dose related and response appeared to persist for more than 2 months with a lower dosing frequency.
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The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013.
Alize J. Ferrari,Alize J. Ferrari,Alize J. Ferrari,Emily Stockings,Jon Paul Khoo,Holly E. Erskine,Holly E. Erskine,Holly E. Erskine,Louisa Degenhardt,Louisa Degenhardt,Louisa Degenhardt,Theo Vos,Harvey Whiteford,Harvey Whiteford,Harvey Whiteford +14 more
TL;DR: The global burden of bipolar disorder based on findings from the Global Burden of Disease Study 2013 (GBD 2013) is presented.
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