Potential gains in life expectancy from reducing amenable mortality among people diagnosed with serious mental illness in the United Kingdom
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BACKGROUND: To estimate the potential gain in life expectancy from addressing modifiable risk factors for all-cause mortality (excluding suicide and deaths from accidents or violence) across specific serious mental illness (SMI) subgroups, namely schizophrenia, schizoaffective disorders, and bipolar disorders in a Western population. METHODS: We have used relative risks from recent meta-analyses to estimate the population attribution fraction (PAF) due to specific modifiable risk factors known to be associated with all-cause mortality within SMI. The potential gain in life expectancy at birth, age 50 and age 65 years were assessed by estimating the combined effect of modifiable risk factors from different contextual levels (behavioural, healthcare, social) and accounting for the effectiveness of existing interventions tackling these factors. Projections for annual gain in life expectancy at birth during a two-decade was estimated using the Annual Percentage Change (APC) formula. The predicted estimates were based on mortality rates for year 2014-2015. RESULTS: Based on the effectiveness of existing interventions targeting these modifiable risk factors, we estimated potential gain in life expectancy at birth of four (bipolar disorders), six (schizoaffective disorders), or seven years (schizophrenia). The gain in life expectancy at age 50 years was three (bipolar disorders) or five (schizophrenia and schizoaffective disorders) years. The projected gain in life expectancy at age 65 years was three (bipolar disorders) or four (schizophrenia and schizoaffective disorders) years. CONCLUSIONS: The implementation of existing interventions targeting modifiable risk factors could narrow the current mortality gap between the general and the SMI populations by 24% (men) to 28% (women). These projections represent ideal circumstances and without the limitation of overestimation which often comes with PAFs.
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Tobacco smoking is recognized as a major factor contributing to the lower life expectancy of persons with mental disorders.
“Tobacco smoking is recognized as a major factor contributing to the lower life expectancy of persons with mental disorders 134,135 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [135]
The Results (Lifestyle risk factors; page unavailable) attribute substantial mortality to smoking in schizophrenia and bipolar disorder, and the Discussion identifies smoking as the best single modifiable candidate for increasing life expectancy in schizophrenia. The paper addresses serious mental illness, so it does not establish the claim for people with mental disorders more broadly. (LLM, conf=0.82)
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- Authors
- Dregan, A., McNeill, A., Gaughran, F., Jones, P. B., Bazley, A., Cross, S., Lillywhite, K., Armstrong, D., Smith, S., Osborn, D. P. J., Stewart, R., Wykes, T., & Hotopf, M.
- Affiliations
- King's College London (GB)
- University of Cambridge (GB)
- South London and Maudsley NHS Foundation Trust (GB)
- University College London (GB)
- Corresponding author
- Dregan, Alex
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2020-03-27
- Volume
- 15
- Issue
- 3
- Pages
- e0230674
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7100972
- OpenAlex
- W3013958660
- Cited by
- 41
- References
- 76
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 13 · 2023: 8 · 2022: 8 · 2021: 4 · 2020: 1
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Eli Lilly and Company
- Biogen
- Stanley Medical Research Institute
- South London and Maudsley NHS Foundation Trust
- Sunovion
- King's College Hospital NHS Foundation Trust
- Maudsley Charity
- European Federation of Pharmaceutical Industries and Associations
- National Institute for Health and Care Research (NF-SI-0514-10028, NF-SI-0515-10102, NF-SI-0617-10125)
- Department of Health and Social Care
- King's College London
- Innovative Medicines Initiative
- H. Lundbeck A/S
- Medical Research Council (MR/T045302/1, MR/S028188/1, MC_PC_17214)
- Engineering and Physical Sciences Research Council (EP/N027280/1)
- National Institute for Health Research Applied Research Collaboration South London
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- severe mental illness, amenable mortality, life expectancy, modifiable risk factors, all-cause mortality, schizophrenia, schizoaffective disorder, bipolar disorder, population attributable fraction, mortality gap, health disparities, intervention effectiveness
- MeSH terms
- Aged, Bipolar Disorder, Female, United Kingdom, Humans, Life Expectancy, Life Style, Male, Middle Aged, Psychotic Disorders, Risk Factors, Schizophrenia, Severity of Illness Index, Meta-Analysis as Topic, Survival Rate, Databases, Factual
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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