All-cause mortality among people with serious mental illness (SMI), substance use disorders, and depressive disorders in southeast London: a cohort study

BMC Psychiatry

Research Article

Matthew Hotopf¹  William Lee¹  Matthew Broadbent²  Robert Stewart²  Chin-Kuo Chang²  Andrea C Fernandes²  Richard D Hayes² 

[1] King's College London, Academic Dept Psychological Medicine, Institute of Psychiatry, London, UK;King's College London, Section of Epidemiology, Dept of Health Service and Population Research, Institute of Psychiatry, London, UK;

关键词: Schizophrenia;    National Health Service;    Depressive Episode;    Schizoaffective Disorder;    Serious Mental Illness;   

DOI  :  10.1186/1471-244X-10-77

 received in 2010-06-23, accepted in 2010-09-30,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundHigher mortality has been found for people with serious mental illness (SMI, including schizophrenia, schizoaffective disorders, and bipolar affective disorder) at all age groups. Our aim was to characterize vulnerable groups for excess mortality among people with SMI, substance use disorders, depressive episode, and recurrent depressive disorder.MethodsA case register was developed at the South London and Maudsley National Health Services Foundation Trust (NHS SLAM), accessing full electronic clinical records on over 150,000 mental health service users as a well-defined cohort since 2006. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information since 2008. Deaths were identified by regular national tracing returns after 2006. Standardized mortality ratios (SMRs) were calculated for the period 2007 to 2009 using SLAM records for this period and the expected number of deaths from age-specific mortality statistics for the England and Wales population in 2008. Data were stratified by gender, ethnicity, and specific mental disorders.ResultsA total of 31,719 cases, aged 15 years old or more, active between 2007-2009 and with mental disorders of interest prior to 2009 were detected in the SLAM case register. SMRs were 2.15 (95% CI: 1.95-2.36) for all SMI with genders combined, 1.89 (1.64-2.17) for women and 2.47 (2.17-2.80) for men. In addition, highest mortality risk was found for substance use disorders (SMR = 4.17; 95% CI: 3.75-4.64). Age- and gender-standardised mortality ratios by ethnic group revealed huge fluctuations, and SMRs for all disorders diminished in strength with age. The main limitation was the setting of secondary mental health care provider in SLAM.ConclusionsSubstantially higher mortality persists in people with serious mental illness, substance use disorders and depressive disorders. Furthermore, mortality risk differs substantially with age, diagnosis, gender and ethnicity. Further research into specific risk groups is required.

【 授权许可】

CC BY   
© Chang et al; licensee BioMed Central Ltd. 2010