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
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Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care
Antoinette Krupski,Imara I. West,Deborah M. Scharf,James Hopfenbeck,Graydon Andrus,Jutta M. Joesch,Mark Snowden +6 more
TL;DR: Investments in PBHCI can improve access to outpatient medical care for persons with severe mental illness and may also curb hospitalizations and associated costs in more established programs.
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Maternal Overnutrition Induces Long-Term Cognitive Deficits across Several Generations.
TL;DR: It is found that MHFD led to cognitive disabilities and an altered response to a noncompetitive receptor antagonist of the N-Methyl-D-aspartic acid (NMDA) receptor in adult MHFD offspring in both second and third generations in a sex-specific manner.
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Smoking Use and Cessation Among People with Serious Mental Illness.
TL;DR: It is suggested that smoking cessation pharmacotherapies are effective for SMI patients and should be offered to those who smoke and Varenicline appeared to be particularly effective.
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"GrimAge," an epigenetic predictor of mortality, is accelerated in major depressive disorder.
Ekaterina Protsenko,Ruoting Yang,Brent Nier,Victor I. Reus,Rasha Hammamieh,Ryan Rampersaud,Gwyneth W. Y. Wu,Christina M. Hough,Christina M. Hough,Elissa S. Epel,Aric A. Prather,Marti Jett,Aarti Gautam,Synthia H. Mellon,Owen M. Wolkowitz +14 more
TL;DR: In this article, the authors investigated the effects of major depressive disorder (MDD) on the epigenetic clock of DNA methylation (GrimAge) and found that individuals with MDD exhibited significantly greater GrimAge relative to their chronological age compared to healthy controls, with a median of 2 years of excess cellular aging.
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Understanding Mental Health for the Prevention and Control of Cardiovascular Diseases
TL;DR: A brief overview of the global burden of mental disorders is provided and selected global strategic research efforts to improve the lives of people with mental disorders and CVD are described.
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