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Natural cause mortality in persons with serious mental illness
F Dickerson1, A Origoni1, J Schroeder2
1Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA.
Acta Psychiatrica Scandinavica
|April 1, 2018
Summary
Smoking significantly increases natural cause mortality risk in individuals with serious mental illness. This modifiable behavior, alongside other factors like divorce and certain health conditions, impacts longevity in this population.
Area of Science:
- Psychiatry and Public Health
- Epidemiology
- Clinical Medicine
Background:
- Serious mental illnesses, including schizophrenia and bipolar disorder, are associated with premature mortality.
- Understanding the specific determinants of natural cause mortality is crucial for targeted interventions.
Purpose of the Study:
- To prospectively identify factors predicting natural cause mortality in a large cohort of individuals diagnosed with serious mental illness.
- To investigate the association between lifestyle, clinical factors, and mortality outcomes.
Main Methods:
- A prospective cohort study involving 1287 individuals with schizophrenia or bipolar disorder.
- In-person clinical assessments, blood sample analysis for infectious disease markers, and mortality follow-up via the National Death Index for up to 16.9 years.
Main Results:
- The natural cause mortality rate was 6.8% (87 individuals).
- Key predictors of mortality included baseline cigarette smoking (RR=6.29), divorced/widowed status (RR=1.90), reduced cognitive scores (RR=0.73), antidepressant use (RR=1.74), elevated Epstein-Barr virus (EBV) antibodies (RR=1.29), and genitourinary, respiratory, or cardiac conditions.
- An additive mortality effect was observed for smoking combined with cardiac or respiratory conditions.
Conclusions:
- Cigarette smoking is a significant, modifiable risk factor for natural cause mortality in individuals with serious mental illness.
- A combination of lifestyle, social, cognitive, and medical factors contribute to increased mortality risk in this population.
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