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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Psychiatry's Role in Improving the Physical Health of Patients With Serious Mental Illness: A Report From the American Psychiatric Association.
TL;DR: An expert panel charged with addressing the role of psychiatry in improving the physical health of persons with serious mental illness developed a set of recommendations grounded in the peer-reviewed and gray literature.
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Meta-analysis of physical activity and effects of social function and quality of life on the physical activity in patients with schizophrenia
Kazutaka Ohi,Yuzuru Kataoka,Takamitsu Shimada,Aki Kuwata,Hiroaki Okubo,Kohei Kimura,Toshiki Yasuyama,Takashi Uehara,Yasuhiro Kawasaki +8 more
TL;DR: The findings suggest that the impaired vigorous PA in schizophrenia patients may be mediated by schizophrenia-specific factors of social functioning and QoL, and has important implications for increasing PA participation in schizophrenic patients.
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The Hotel Study—Clinical and Health Service Effectiveness in a Cohort of Homeless or Marginally Housed Persons:
William G. Honer,Alejandro Cervantes-Larios,Andrea A. Jones,Fidel Vila-Rodriguez,Julio S. G. Montaner,Howard Tran,Jimmy Nham,William J. Panenka,Donna J. Lang,Allen E. Thornton,Talia Vertinsky,Alasdair M. Barr,Ric M. Procyshyn,Geoffrey N. Smith,Tari Buchanan,Mel Krajden,Michael Krausz,G. William MacEwan,Kristina M. Gicas,Olga Leonova,Verena Langheimer,Alexander Rauscher,Krista Schultz +22 more
TL;DR: Mapping confirmed the association between poverty and greater number of emergency visits related to substance use and mental illness and assessed the clinical effectiveness of existing, illness-specific treatment strategies and health care delivery for multimorbid illnesses.
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Mortality and use of psychotropic medication in patients with stroke: a population-wide, register-based study.
TL;DR: All-cause mortality was higher in patients with stroke and controls treated with benzodiazepines, antidepressants and antipsychotics than in their untreated counterparts, and Interaction analysis suggested statistically significantly higher mortality HRs for most classes of psychotropic drugs in controls compared with patients with strokes.
Book ChapterDOI
Global Priorities for Addressing the Burden of Mental, Neurological, and Substance Use Disorders
Vikram Patel,Dan Chisholm,Rachana Parikh,Fiona J Charlson,Louisa Degenhardt,Tarun Dua,Alize J. Ferrari,Steven E. Hyman,Ramanan Laxminarayan,Carol Levin,Crick Lund,María Elena Medina-Mora,Inge Petersen,James Scott,Rahul Shidhaye,Lakshmi Vijayakumar,Graham Thornicroft +16 more
TL;DR: The third edition of the Disease Control Priorities (DCP) project as mentioned in this paper addressed mental, neurological, and substance use (MNS) disorders, which are a heterogeneous range of disorders that owe their origin to a complex array of genetic, biological, psychological, and social factors.
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