Contributions of specific causes of death to lost life expectancy in severe mental illness
Open accessAbstract
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.
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Approximately 79% of the disparity in life expectancy between individuals with SMI and the general population can be linked to cardiovascular, respiratory, cancer, metabolic, and infectious diseases.
“approximately 79% of the disparity in life expectancy between individuals with SMI and the general population can be linked to cardiovascular, respiratory, cancer, metabolic, and infectious diseases [17].”
From A retrospective and comprehensive analysis of excess life-years lost, mortality risk, and cause of death among severe mental illness in China (2025) · cites this paper as [17]
The Abstract (p. 3) attributes 79.2% of lost life-years in women and 78.6% in men to natural causes as a whole, not to the five disease groups listed in the claim. The Results (p. 7) distinguish circulatory, cancer and respiratory diseases from gastrointestinal diseases and other remaining causes; they do not assign the approximately 79% figure to the claimed grouping, including metabolic and infectious diseases. (LLM, conf=0.90)
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- Authors
- Jayatilleke, N., Hayes, R. D., Dutta, R., Shetty, H., Hotopf, M., Chang, C.-K., & Stewart, R.
- Affiliations
- King's College London (GB)
- Corresponding author
- Chang, C.-K.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-06
- Volume
- 43
- Pages
- 109-115
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2593589288
- Cited by
- 111
- References
- 30
- Citations by year
- 2026: 4 · 2025: 21 · 2024: 11 · 2023: 15 · 2022: 16 · 2021: 15 · 2020: 8 · 2019: 11 · 2018: 8 · 2017: 2
- FWCI
- 11.36
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Funders
- Clinical Records Interactive Search (CRIS)
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London
- Maudsley NHS Foundation Trust and King's College London
- Guy's and St. Thomas’ Charity and the Maudsley Charity (BRC-2011-10035)
- Medical Research Council (MRC) Population Health Scientist Fellowship (MR/J01219X/1)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- severe mental illness, life expectancy, life expectancy gap, causes of death, mortality, circulatory diseases, cancer, respiratory diseases, suicide, gender differences, mood disorders
- MeSH terms
- Aged, Aged, 80 and over, Mental Disorders, Cardiovascular Diseases, Cause of Death, England, Female, Humans, Life Expectancy, Male, Middle Aged, Neoplasms, Suicide, Cohort Studies
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