Abstract
Background
People with serious mental illness (SMI) have a significantly shorter life expectancy than the general population. This study investigates whether the mortality rate in this group has changed over the last decade.
Methods
Using Clinical Record Interactive Search (CRIS) software, we extracted data from a large electronic database of patients in South East London. All patients with schizophrenia, schizoaffective disorder or bipolar affective disorder from 2008-2012 and/or 2013-2017 were included. Estimates of life expectancy at birth, standardized mortality ratios and causes of death were obtained for each cohort according to diagnosis and gender. Comparisons were made between cohorts and with the general population using data obtained from UK Office of National Statistics.
Results
26,005 patients were included. In men, life expectancy was greater in 2013-2017 (64.9 years; 95% CI: 63.6-66.3) than in 2008-2012 (63.2 years; 95% CI: 61.5-64.9). Similarly, in women, life expectancy was greater in 2013-2017 (69.1 years; 95% CI: 67.5-70.7) than in 2008-2012 (68.1 years; 95% CI: 66.2-69.9). The difference with general population life expectancy fell by 0.9 years between cohorts in men, and 0.5 years in women. In the 2013-2017 cohorts, cancer accounted for a similar proportion of deaths as cardiovascular disease.
Conclusions
Relative to the general population, life expectancy for people with SMI is still much worse, though it appears to be improving. The increased cancer-related mortality suggests that physical health monitoring should consider including cancer as well.
People with serious mental illness (SMI) have a significantly shorter life expectancy than the general population. This study investigates whether the mortality rate in this group has changed over the last decade.
Methods
Using Clinical Record Interactive Search (CRIS) software, we extracted data from a large electronic database of patients in South East London. All patients with schizophrenia, schizoaffective disorder or bipolar affective disorder from 2008-2012 and/or 2013-2017 were included. Estimates of life expectancy at birth, standardized mortality ratios and causes of death were obtained for each cohort according to diagnosis and gender. Comparisons were made between cohorts and with the general population using data obtained from UK Office of National Statistics.
Results
26,005 patients were included. In men, life expectancy was greater in 2013-2017 (64.9 years; 95% CI: 63.6-66.3) than in 2008-2012 (63.2 years; 95% CI: 61.5-64.9). Similarly, in women, life expectancy was greater in 2013-2017 (69.1 years; 95% CI: 67.5-70.7) than in 2008-2012 (68.1 years; 95% CI: 66.2-69.9). The difference with general population life expectancy fell by 0.9 years between cohorts in men, and 0.5 years in women. In the 2013-2017 cohorts, cancer accounted for a similar proportion of deaths as cardiovascular disease.
Conclusions
Relative to the general population, life expectancy for people with SMI is still much worse, though it appears to be improving. The increased cancer-related mortality suggests that physical health monitoring should consider including cancer as well.
| Original language | English |
|---|---|
| Journal | Psychological Medicine |
| Publication status | Accepted/In press - 31 May 2020 |
