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Contributions of specific causes of death to lost life expectancy in severe mental illness

Published online by Cambridge University Press:  23 March 2020

N. Jayatilleke ,
R.D. Hayes ,
R. Dutta ,
H. Shetty ,
M. Hotopf ,
C.-K. Chang  and
R. Stewart
N. Jayatilleke
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
R.D. Hayes
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
R. Dutta
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
H. Shetty
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
M. Hotopf
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
C.-K. Chang*
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
R. Stewart
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine Dept, King's College London, PO Box 92, De Crespigny ParkLondonSE5 8AF, United Kingdom
*
*Corresponding author. Tel.: +44 2032 288 590; fax: +44 2032 288 551. E-mail address:chin-kuo.chang@kcl.ac.uk (C.-K. Chang).
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Abstract

The life expectancy gap between people with severe mental illness (SMI) and the general population persists and may even be widening. This study aimed to estimate contributions of specific causes of death to the gap. Age of death and primary cause of death were used to estimate life expectancy at birth for people with SMI from a large mental healthcare case register during 2007–2012. Using data for England and Wales in 2010, death rates in the SMI cohort for each primary cause of death category were replaced with gender- and age-specific norms for that cause. Life expectancy in SMI was then re-calculated and, thus, the contribution of that specific cause of death estimated. Natural causes accounted for 79.2% of lost life-years in women with SMI and 78.6% in men. Deaths from circulatory disorders accounted for more life-years lost in women than men (22.0% versus 17.4%, respectively), as did deaths from cancer (8.1% versus 0%), but the contribution from respiratory disorders was lower in women than men (13.7% versus 16.5%). For women, cancer contributed more in those with non-affective than affective disorders, while suicide, respiratory and digestive disorders contributed more in those with affective disorders. In men, respiratory disorders contributed more in non-affective disorders. Other contributions were similar between gender and affective/non-affective groups. Loss of life expectancy in people with SMI is accounted for by a broad range of causes of death, varying by gender and diagnosis. Interventions focused on multiple rather than individual causes of death should be prioritised accordingly.

Keywords

Severe mental illnessSchizophreniaBipolar disorderLife expectancyCause of deathPhysical illness
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 109 - 115
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

1

Joint last authors.

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