Mental Illness and Mortality

Last night when my brain was car-crashing, I was reading about 10 articles per five minutes. One them was this about serious mental illness and mortality.

That was the article that triggered my panic attack. Here’s another:


 

Clinical & Research News

Death Data Have Researchers Searching for Answers Eve Bender

People with serious mental illness are dying at higher rates and at earlier ages than people in the general population who don’t have mental illness.

Metabolic dysfunction caused by some medications may play a role. People with serious mental illness in one sample of psychiatric inpatients had more than three times the rate of death of those in the general population without mental illness and died an average of 32 years earlier.

The leading causes of death among people in the sample, most of whom were diagnosed with a psychotic disorder, were heart disease, suicide, accidents, and cancer.

The findings call for increased screening and monitoring of patients with serious mental illness for medical comorbidities, according to the authors of the study, published in the October Psychiatric Services.

Researchers collected medical information on 20,018 patients hospitalized on at least one occasion at one of nine hospital sites associated with five behavioral health care organizations in Ohio’s public mental health system between 1998 and 2002.

They matched patients’ hospital records with death records from the Ohio Department of Health and identified 608 patients who died during the four-year period (hospital deaths were included in the sample).

The patients who died had been diagnosed with a number of mental disorders, including schizophrenia (134), schizoaffective disorder (128), alcohol abuse (101), bipolar disorder (87), alcohol dependence (85), major depressive disorder (80), cannibis abuse (59), other mixed or unspecified drug abuse (56), and cocaine abuse (35). The majority of patients in the sample died from heart disease (126), suicides (108), accidents (83), or cancer (44).

Researchers also measured years per life lost for those who died, which is a measure of premature death based on the current mean survival age for a cohort matched by age and gender in the general population. Patients with serious mental illness died an average of 32 years earlier than patients in the general population, according to the findings.

The average age of death for the people in the sample was 47.7 years. When researchers calculated the standard mortality ratio for patients in the sample who died, they found 3.2 times the rate of death as that of the general U.S. population.

The most prevalent comorbid medical conditions for patients in the sample who died included obesity (144), hypertension (136), diabetes (70), chronic obstructive pulmonary disease (62), and injuries (39). Among the 126 patients who died of heart disease, leading comorbidities included hypertension, obesity, diabetes, chronic obstructive pulmonary disease, and disorders of lipid metabolism.

Previous research has yielded similar results. For example, a report released by the federal Centers for Disease Control and Prevention in April said that patients with schizophrenia or bipolar disorder lose as much as 20 years off their average life expectancy compared withsimilar individuals in the general population without seriousmental illness and had elevated rates of heart disease (Psychiatric News, July 7).

At a 2004 meeting convened by the American Diabetes Association and attended by several APA members, the organization issued a consensus statement confirming the risk of metabolic changes associated with second-generation anti-psychotics and calling for careful monitoring of patients on these medications.

In the study of hospitalized patients with serious mental illness in Ohio, researchers could not draw conclusions about cause of death. They speculated, however, that underlying factors may have included medication-induced weight gain, poor personal hygiene, reduced physical activity, increased prevalence of smoking and substance use, and inadequate social support, according to C. Bayard Paschall III, Ph.D., chief of the Ohio Department of Mental Health’s Office of Performance Improvement.

“The question is how we tease some of these characteristics away” from others to be able to associate them with cause of death for patients with serious mental illness, Paschall told Psychiatric News.

Study findings indicate a need for closer collaboration between psychiatry and primary care, according to lead author Brian Miller, M.D., M.P.H., a PGY-2 psychiatry resident at the Medical College of Georgia. In ideal circumstances, patients with serious mental illness could walk from their psychiatrist’s office to an office across the hall to see a primary care physician “who might screen them for some of the comorbid medical conditions we observed in our study,” he said.

In addition, he suggested that psychiatrists and other physicians treating patients who take second-generation antipsychotics carefully monitor these patients for side effects associated with metabolic dysfunction and also write orders for tests of fasting blood glucose, lipid profiles, and liver and thyroid function. Miller and Paschall are conducting further research on some of the factors that may be contributing to excess death rates among people with serious mental illness.

 


 

I’m not sure what to draw from that as they don’t mention if the alcohol/drug abuse is co-morbid with mental illnesses. Still, it is sobering and frightening. Especially given just how low on the agenda mental illness is in Britain.

My dad died right on the money- aged 47.11 years.

20 Responses

  1. Are you kidding? Over 60% of Bi Polar patients present with a co morbidity of alcoholism. The main theory is that because it takes on average 11 years from first entering the health system, to being properly diagnosed as Bi Polar, these 60% have been busy shoving booze and what ever else down their throats in an increasingly desperate attempt to self medicate. I should know, as I am one of this majority.

    I am 35, so that gives me 12 years.

    On a brighter note, I think you are a star, a genuine talent, hell, a voice.

    I look forward to reading your novel.

    James.

  2. this gives me about 3 years to live-scary thought

  3. At the risk of giving you another panic attack have you read the following?

    http://seroxatsecrets.wordpress.com/

    http://clinpsyc.blogspot.com/2007/03/whose-gold-standard.html#links

    I think Eli Lilly the makers of Olanzapine may be facing legal action in the US for concealing the risks of developing Diabetes through taking their drug. See

    http://ahrp.blogspot.com/search/label/Zyprexa

  4. james has a point – self medication can be just as dangerous as the illness itself. i’ve often thought they should class BP and such as fatal illnesses, but then i think our outlooks on death are totally poles apart.

    having said all that – i have now got a LOT of physical problems which are almost certainly BP induced. i have fibromyalgia which is like M.E but with painful joints thrown in for good measure, and i have hypothyroidism (lithium induced) – both of which mean i’ve gained about 6 dress sizes over the last year. and of course i’m so tired and painful all the time, exercise, the one thing that would help me lose the weight, is counterproductive because if i walk for 20 mins i can hardly move for days afterwards.

    it’s infuriating, to be honest, i’m stable, mentally, but i feel like a pensioner at the age of 30 which is pretty depressing in itself.

    sorry to be the bearer of bad tidings but i was “surprised” to find out after years of lithium/mania/antipsychotics etc that these things have quite serious long term, physical side effects that no one had bothered to warn me about – now i feel fucking dreadful most of the time (to the point where i rarely mention it apart from on LJ because i dread sounding like a broken record) and there’s very ltitle i can do about it (partly because the main treatment for FM is anti-inflammatories which – hey presto – can make lithium go toxic, so i can’t take them – yay!!).

  5. Molloy I am not using your staggeringly good { you haven’t been as prolflic lately } blog as a chat room….but, to reply to dogtanian briefly.
    1: With a 20 % suicide rate {untreated}, bi polar must be a fatal illness.
    2:What the hell is it with hypothyroidism, I also have that, but mine is co morbid, not lithium induced. I wonder if the writer of this blog has it, because it is very much in bed with rapid cycling.
    3: Have you tried a cross trainer for exercise? Limited joint impact.

  6. that’s the thing with the old thyroid – you either get it as a partner in crime with BP or as a result of the treatment for BP – what a great choice😀

    i used to rather enjoy cross trainers in the gym (well, inasmuch as anything in a gym is enjoyable) – perhaps i shall try again.

  7. James- nope, no hyperthrroidism here.

  8. do you believe nuerofeedback can increase blood flow , when you were born with severe brain trauma at birth from rhneg factor now age 54

  9. do you think that neurofeedback will help the blood flow after severe brain trauma from birth, now age 54/ from rhneg factor

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  12. they’ll have you suicidal suicida. Nurit Hailey.

  13. […] as I’ve had tons of near misses).  Mental illness, across the board, decreases life span.  In this study, the average age of death was forty seven.  Forty seven, when the average human life span is over seventy years […]

  14. Sobering stuff. I found your blog a month or so ago, having been yet another mid 30’s person *finally* caught up with by the white-coat brigade… (There’s nothing like having 3 children to finally flush it out of the woodwork again). 47 eh? Oh well, it could always be worse!

    Your blog is super btw – I must stop reading it right now and go to bed!!!

    atb David

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