Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia

Abebaw Fekadu, Girmay Medhin, Derege Kebede, Atalay Alem, Anthony J Cleare, Martin Prince, Charlotte Hanlon, Teshome Shibre

Research output: Contribution to journalArticlepeer-review

122 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)289-296
Number of pages8
JournalThe British journal of psychiatry : the journal of mental science
Volume206
Issue number4
DOIs
Publication statusPublished - Apr 2015

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