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Cited by 53Schizophrenia research and treatmentSuicide and Self-Harm StudiesMental Health Treatment and Access

Mortality in first-contact psychosis patients in the UK: a cohort study

Dutta, R., Murray, R. M., Allardyce, J., Jones, P. B., Boydell, J. E.·2012·Psychological Medicine
DOI 10.1017/s0033291711002807
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Abstract

BACKGROUND: The excess mortality following first-contact psychosis is well recognized. However, the causes of death in a complete incidence cohort and mortality patterns over time compared with the general population are unknown. METHOD: All 2723 patients who presented for the first time with psychosis in three defined catchment areas of the U.K. in London (1965-2004, n=2056), Nottingham (1997-1999, n=203) and Dumfries and Galloway (1979-1998, n=464) were traced after a mean of 11.5 years follow-up and death certificates were obtained. Data analysis was by indirect standardization. RESULTS: The overall standardized mortality ratio (SMR) for first-contact psychosis was 184 [95% confidence interval (CI) 167-202]. Most deaths (84.2%, 374/444) were from natural causes, although suicide had the highest SMR (1165, 95% CI 873-1524). Diseases of the respiratory system and infectious diseases had the highest SMR of the natural causes of death (232, 95% CI 183-291). The risk of death from diseases of the circulatory system was also elevated compared with the general population (SMR 139, 95% CI 117-164) whereas there was no such difference for neoplasms (SMR 111, 95% CI 86-141). There was strong evidence that the mortality gap compared with the general population for all causes of death (p<0.001) and all natural causes (p=0.01) increased over the four decades of the study. There was weak evidence that cardiovascular deaths may be increasing relative to the general population (p=0.07). CONCLUSIONS: People with first-contact psychosis have an overall mortality risk that is nearly double that of the general population. Most excess deaths are from natural causes. The widening of the mortality gap over the last four decades should be of concern to all clinicians involved in delivering healthcare.

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Authors
Dutta, R., Murray, R. M., Allardyce, J., Jones, P. B., & Boydell, J. E.
Affiliations
  • King's College London (GB)
  • Maastricht University (NL)
  • University of Cambridge (GB)
Corresponding author
Dutta, R.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2011-12-13
Volume
42
Issue
8
Pages
1649-1661
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291711002807
OpenAlex
W1985021334
Cited by
53
References
45
Citations by year
2025: 1 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 8 · 2017: 4 · 2016: 7 · 2015: 4 · 2014: 7 · 2013: 7
FWCI
3.08
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • British Medical Association
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
psychosis, excess mortality, standardized mortality ratio, suicide, natural death, cardiovascular mortality, respiratory diseases, infectious diseases
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Bipolar Disorder, Cause of Death, Death Certificates, Female, United Kingdom, Humans, Male, Middle Aged, Mortality, Neoplasms, Psychotic Disorders, Rural Population, Schizophrenia, Suicide, Urban Population, Cohort Studies, Incidence, Sex Distribution, Kaplan-Meier Estimate, Young Adult

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