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The Epidemiology of Excess Mortality in People with Mental Illness
Open accessAbstract
OBJECTIVE: to investigate the burden of excess mortality among people with mental illness in developed countries, how it is distributed, and whether it has changed over time. METHOD: we conducted a systematic search of MEDLINE, restricting our attention to peer-reviewed studies and reviews published in English relating to mortality and mental illness. Because of the large number of studies that have been undertaken during the last 30 years, we have selected a representative cross-section of studies for inclusion in our review. RESULTS: there is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death. Consistently elevated rates have been observed across settings and over time. The highest numbers of excess deaths are due to cardiovascular and respiratory diseases. With life expectancy increasing in the general population, the disparity in mortality outcomes for people with mental illness is increasing. CONCLUSIONS: without the development of alternative approaches to promoting and treating the physical health of people with mental illness, it is possible that the disparity in mortality outcomes will persist.
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“Lawrence et al. (2010) concluded that insufficient health service for schizophrenic patients with cardiovascular disease may explain part of the increased mortality from natural causes.”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Lawrence et al. 2010
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“CVD accounts for much of the excess mortality in psychiatric patients.442”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [442]
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Shukla, A. P., Mandel, L., Tchang, B. G., Litman, E. A., Cadwell, J. B., Kumar, R. B., Waitman, J. A., Igel, L. I., Christos, P. J., & Aronne, L. J. (2020) · Obesity · doi:10.1002/oby.22903 · Cited by 6
“There are several putative mechanisms linking mental illness with obesity, including adverse health behaviors (10); neurohormonal imbalances at emotional, cognitive, and energy homeostatic centers in the brain (11); and psychotropic drug–induced weight gain (12,13).”
BackgroundZammarchi, G., Conversano, C., & Pisanu, C. (2022) · Algorithms · doi:10.3390/a15110409 · Cited by 5
Tavares, V. D. D. O., Coelho, N. L. G., Firth, J., Rosenbaum, S., Stubbs, B., Smith, L., Vancampfort, D., & Schuch, F. B. (2020) · Journal of Physical Activity and Health · doi:10.1123/jpah.2020-0312 · Cited by 4
Continuity of care and mortality in people with schizophrenia
Macdonald, A., Adamis, D., Broadbent, M. T. M., Craig, T., Stewart, R. J., & Murray, R. M. (2021) · BJPsych Open · doi:10.1192/bjo.2021.965 · Cited by 4
Rönngren, Y., Björk, A., Haage, D., & Audulv, Å. (2024) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2344805 · Cited by 4
“The reduced life expectancy of persons living with SMI may also be related to their higher likelihood of having unhealthy lifestyles, including poor eating and exercise habits, smoking, and the use of drugs and alcohol (Kalinowska et al., 2021; Lawrence et al., 2010; Scott & Happell, 2011).”
Self‐management of chronic disease in individuals with psychotic disorder: A qualitative study
Adıbelli, D., & Özkan, İ. (2020) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12598 · Cited by 5
“1,3 Although common chronic conditions such as heart diseases, diabetes, and arthritis have different effects on patients, there may be difficulties related to their management.”
Runnels, P. S., Muskin, R., Ansah, A., Penman, J., & Pronovost, P. J. (2022) · Population Health Management · doi:10.1089/pop.2022.0013 · Cited by 4
Hearing Voices: Evaluation of a Medical Student Training Experience About Psychosis
Smith, M. K., Tamburrino, M., Naskar, I., Lynch, D. J., & Chen, Y. (2014) · Academic Psychiatry · doi:10.1007/s40596-014-0166-z · Cited by 4
“Lawrence et al [1] have shown that persons with severe mental illness experience a lower level of medical care compared to persons without mental illness.”
BackgroundRiesgo suicida y desesperanza en pacientes psiquiátricos hospitalizados
Montaño, S. H., Zableh, A. V., Caamaño, B. H., & Ospino, G. A. C. (2014) · Pensando Psicología · doi:10.16925/pe.v10i17.783 · Cited by 4
Lessons Learned From the Trial of a Cardiometabolic Health Nurse
Happell, B., Hodgetts, D., Stanton, R., Millar, F., Platania‐Phung, C., & Scott, D. S. (2014) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12091 · Cited by 4
Antipsychotics: features of undesirable adverse reactions in elderly and senile age
Ostroumova, O. D., Васильевна, Г. И., Isaev, R. I., & Pereverzev, A. P. (2019) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro2019119021105 · Cited by 4
Aldea, M. S., Zarrabeitia, M. T., Blanco, A., & Santurtún, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315867 · Cited by 3
“Psychiatric illnesses are associated with a higher risk of premature mortality from both natural and unnatural causes [35].”
BackgroundBouthillier, M.-É., & Vaillancourt, H. (2020) · Canadian Journal of Bioethics · doi:10.7202/1073546ar · Cited by 3
“Les risques associés au style de vie, des soins physiques sous-optimaux et du sousdiagnostic de certaines conditions physiques (cardiaques ou respiratoires) figurent au nombre des causes de mortalité chez ces personnes (4-7).”
BackgroundZagożdżon, P., Dorozynski, P., Waszak, P. M., Harasimowicz, A., & Dziubich, T. (2022) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2022.06.002 · Cited by 3
Okuma, A., Nakajima, M., Sonoo, T., Nakamura, K., & Goto, T. (2023) · Acute Medicine & Surgery · doi:10.1002/ams2.814 · Cited by 3
Gong, I. Y., Cheung, M. C., Chan, K., Arya, S., Faught, N., Calzavara, A. J., Liu, N., Odejide, O. O., Abel, G. A., Kurdyak, P. A., et al. (2023) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djad149 · Cited by 3
Osman, A. H. M., Abdalhai, K. A., Hassan, I., Elmubark, M. A., & Elawad, L. A. (2020) · Middle East Current Psychiatry · doi:10.1186/s43045-020-00052-x · Cited by 4
“On the other hand, mentally ill patients are at risk of suffering the consequences of inherent features of their illnesses, such as a lack of motivation, self-neglect, apathy, cognitive impairments, drug and/or alcohol problems, homelessness and poverty, resulting in malnutrition, vitamin deficiency, liver and lung di…”
BackgroundSecular trends in the interest of physical health in patients with mental illness
Kristiansen, C. B., & Vestergaard, C. H. (2015) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12474 · Cited by 3
Defining a valid day of accelerometer monitoring in adults with mental illness
Chapman, J. J., Brown, W. J., & Burton, N. W. (2015) · Mental health and physical activity · doi:10.1016/j.mhpa.2015.09.003 · Cited by 3
Bradley, S. C., Doucet, R., Kohler, E., & Drapeau, M. (2016) · Santé mentale au Québec · doi:10.7202/1036099ar · Cited by 3
Fehily, C. M. C., Bartlem, K. M., Wiggers, J. H., Wolfenden, L., Regan, T., Dray, J., Bailey, J. M., & Bowman, J. (2018) · Systematic Reviews · doi:10.1186/s13643-018-0735-4 · Cited by 3
Bressington, D. T., Li, Y., Hulbert, S., & Mak, Y. W. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17103564 · Cited by 3
“Although CVD in people with mental illness are common, they are often diagnosed late and treatments may be inadequate [2].”
BackgroundMortality among Patients with Severe Mental Disorders from a Rural Community in South India
Raghavan, V., Rao, S., Kulandesu, A., Karthick, S., Gunaselvi, S., Senthilkumar, S. N., Rao, K., John, S., & THARA, R. (2021) · Indian Journal of Social Psychiatry · doi:10.4103/ijsp.ijsp_337_20 · Cited by 3
Metadata
- Authors
- Lawrence, D., Kisely, S., & Pais, J.
- Affiliations
- The Kids Research Institute Australia (AU)
- Professor and Director, The University of Queensland, Health LinQ: The Queensland Centre for Health Data Services, Brisbane, Australia; Professor, Department of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia
- The University of Queensland (AU)
- Corresponding author
- Lawrence, David
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2010-12
- Volume
- 55
- Issue
- 12
- Pages
- 752-760
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W149077341
- Cited by
- 258
- References
- 103
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 14 · 2023: 19 · 2022: 16 · 2021: 18 · 2020: 25 · 2019: 16 · 2018: 15 · 2017: 12 · 2016: 19 · 2015: 18 · 2014: 22 · 2013: 24 · 2012: 15
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- eSpace (Curtin University) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- excess mortality, mental illness, cardiovascular disease, respiratory diseases, life expectancy, mortality disparities, physical health of people with mental illness, causes of death
- MeSH terms
- Mental Disorders, Cardiovascular Diseases, Cause of Death, Humans, Respiratory Tract Diseases, Risk Factors, Schizophrenia, Mood Disorders
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