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Cited by 170Mental Health Treatment and AccessSuicide and Self-Harm StudiesPsychiatric care and mental health services

Cause-specific life-years lost in people with mental disorders: a nationwide, register-based cohort study

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Erlangsen, Annette, Andersen, Per Kragh, Toender, Anita, Laursen, Thomas Munk, Nordentoft, Merete, Canudas-Romo, Vladimir·2017·The Lancet Psychiatry
DOI 10.1016/s2215-0366(17)30429-7
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Abstract

BACKGROUND: People with mental disorders have higher mortality rates than the general population and more detailed estimates of mortality differences are needed to address this public health issue. We aimed to assess whether differences in cause-specific mortality between people with and without mental disorders have changed between 1995 and 2014 by quantifying life-years lost and assessing differences over time. METHODS: Using a cohort design, we linked nationwide population data from the Danish Civil Registration System to information about hospital contacts from the Psychiatric Central Research Register and deaths from the Danish Cause of Death register. All linked data sources contained longitudinal information covering all individuals aged 15-94 years living in Denmark between 1995 and 2014. We assessed cause-specific mortality differences using rate ratios and average life-years lost. FINDINGS: Between 1995 and 2014, 6 107 234 individuals (3 026 132 men and 3 081 102 women) aged 15-94 years were living in Denmark. The study population was observed over 89 216 177 person-years (men: 43 914 948; women 45 301 229). Cause-specific mortality rates were higher for people with mental disorders than those without (total mortality rate per 1000 person-years in men 27·1 vs 11·4, respectively, and in women 21·2 vs 11·0). When compared with individuals without mental disorders, men and women with mental disorders had 10·20 and 7·34 excess life-years lost, respectively. The largest cause-specific differences between those with and without mental disorders in terms of excess life-years lost were for respiratory diseases (men: 0·9; women: 1·4) and alcohol misuse (men: 2·8; women: 1·2). Between 1995 and 2014, we noted an increase in excess life-years lost for neoplasms (men: 0·7; women: 0·4), heart diseases (men: 1·2; women: 0·3), and respiratory diseases (men: 0·3; women: 0·2), and a decrease for suicide (men: -0·7; women: -0·5) and accidents (men: -0·9; women: -0·5). INTERPRETATION: By applying a novel approach, more precise estimates of life-years lost were obtained. The increase in excess mortality due to medical diseases and disorders among people with mental disorders emphasises the need for future interventions to address these aspects as well as the continued high shares of excess mortality due to alcohol misuse, suicide, and accidents. FUNDING: The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH).

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Authors
Erlangsen, A., Andersen, P. K., Toender, A., Laursen, T. M., Nordentoft, M., & Canudas-Romo, V.
Affiliations
  • University of Copenhagen (DK)
  • Aarhus University (DK)
Corresponding author
Erlangsen, Annette
ORCID
Venue
The Lancet Psychiatry
Publisher
Elsevier BV
Published
2017-12
Volume
4
Issue
12
Pages
937-945
ISSN
2215-0366 (ISSN-L)
DOI
10.1016/s2215-0366(17)30429-7
OpenAlex
W2767455776
Cited by
170
References
31
Citations by year
2026: 7 · 2025: 23 · 2024: 19 · 2023: 26 · 2022: 22 · 2021: 31 · 2020: 16 · 2019: 11 · 2018: 14 · 2017: 1
FWCI
16.44
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • ANU Open Research (Australian National University) (submittedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
Lundbeckfonden (R155-2014-1724)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
mental illness, cause-specific mortality, years of life lost, mortality trends, suicide, alcohol abuse, respiratory diseases, heart disease, neoplasms, accidents, sex differences, Denmark
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Cause of Death, Denmark, Female, Humans, Male, Middle Aged, Mortality, Registries, Suicide, Cohort Studies, Young Adult

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