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October 28, 2019
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People with mental disorders die significantly earlier than general population

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Individuals with mental disorders have significantly higher mortality rates than the general population, according to results of a Danish register-based cohort study published in The Lancet.

“It is well known that people with mental disorders die earlier than the general population,” Oleguer Plana-Ripoll, PhD, of the National Centre for Register-based Research at Aarhus University in Denmark, said in a press release. “However, for the first time, we present a comprehensive study where we investigate mortality in specific types of mental disorders. We have used new ways to measure life expectancy that are more accurate than the ones used in the past.”

Plana-Ripoll and colleagues included all people aged 95 years or younger who lived in Denmark at some point between January 1995 and December 2015. They obtained date and cause of death from the Danish Register of Causes of Death and data on mental disorders from the Danish Psychiatric Central Research Register. They categorized mental disorders into 10 groups and causes of death into 11 groups, and deaths were further broken down by natural causes, including diseases and medical conditions, and external causes, including suicide, homicide and accidents. The researchers estimated mortality rate ratios for each mental disorder using Poisson regression models that adjusted for sex, age and calendar time, and they also estimated excess life-years lost for all-cause mortality and for each cause of death.

Of the 7,369,926 people included in the analysis, mortality rates were higher for those diagnosed with a mental disorder than for the general Danish population (28.7 deaths vs. 12.95 deaths per 1,000 person-years). Further, the researchers found that all types of disorders were associated with higher mortality rate ratios, which ranged from 1.92 (95% CI, 1.91-1.94) for mood disorders to 3.91 (95% CI, 3.87-3.94) for substance use disorders. All types of mental disorders were linked to shorter life expectancies. Excess life-years lost ranged from 5.42 years (95% CI, 5.36-5.48) for organic disorders in females to 14.84 years (95% CI, 14.7-14.99) for substance use disorders in males. Overall, men and women with mental disorders on average had life expectancies respectively 10 and 7 years shorter after diagnosis compared with the general population.

“Our findings highlight the need for coordinated care of general medical conditions in those with mental disorders,” the researchers wrote. “For example, clinicians can be encouraged to routinely collect physical health outcomes related to comorbid general medical conditions in the patient population.” – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.