Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia
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Background: Evidence on mortality in severe mental illness (SMI) comes primarily from clinical samples in high-income countries. Aims: To describe mortality in people with SMI among a population cohort from a low-income country. Method: We followed-up 919 adults (from 68 378 screened) with SMI over 10 years. Standardised mortality ratios (SMR) and years of life lost (YLL) as a result of premature mortality were calculated. Results: In total 121 patients (13.2%) died. The overall SMR was twice that of the general population; higher for men and people with schizophrenia. Patients died about three decades prematurely, mainly from infectious causes (49.6%). Suicide, accidents and homicide were also common causes of death. Conclusions: Mortality is an important adverse outcome of SMI irrespective of setting. Addressing common natural and unnatural causes of mortality are urgent priorities. Premature death and mortality related to self-harm should be considered in the estimation of the global burden of disease for SMI.
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The mortality rate among individuals with SMI is estimated to be 2 to 3 times higher than that of the general population.
“the mortality rate among individuals with SMI is estimated to be 2 to 3 times higher than that of the general population [9, 10].”
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 [10]
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Proposed Training Areas for Global Mental Health Researchers
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Self-citation
- Authors
- Fekadu, A., Medhin, G., Kebede, D., Alem, A., Cleare, A. J., Prince, M., Hanlon, C., & Shibre, T.
- Affiliations
- King's College London (GB)
- Corresponding author
- Fekadu, Abebaw
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2015-04
- Volume
- 206
- Issue
- 4
- Pages
- 289-296
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2091355806
- Cited by
- 184
- References
- 49
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 14 · 2023: 23 · 2022: 14 · 2021: 27 · 2020: 19 · 2019: 12 · 2018: 15 · 2017: 14 · 2016: 15 · 2015: 5 · 2014: 1
- FWCI
- 26.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- World Health Organization
- 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, mortality, premature mortality, schizophrenia, suicide, infectious disease mortality, years of life lost, global burden of disease, rural Ethiopia, low-income countries
- MeSH terms
- Accidents, Adolescent, Adult, Bipolar Disorder, Cause of Death, Depression, Ethiopia, Female, Homicide, Humans, Male, Middle Aged, Poverty, Rural Population, Schizophrenia, Suicide, Cohort Studies, Sex Distribution, Young Adult
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