Premature deaths among schizophrenics
Despite improvements in mental health care, people with schizophrenia or bipolar disorder still face a "persistent and increasing"risk of premature death compared with the general population, concludes a study published on bmj.com.
The findings highlight the challenge faced by the UK government’s recent mental health strategy, which states that "fewer people with mental health problems will die prematurely."
People with schizophrenia and bipolar disorder are known to have a higher risk of premature death than the general population, both as a result of natural and unnatural causes, including suicide. Recent evidence suggests that the rate of suicide has been stabilising among people with mental illness in the UK, but little is known more generally about mortality trends over time.
So researchers at the University of Oxford and the Institute of Psychiatry, King’s College London analysed records for all people in England discharged from inpatient care with a diagnosis of schizophrenia or bipolar disorder and compared their mortality with the general population from 1999 to 2006. Their aim was to investigate whether the mortality gap has narrowed in recent years.
They found a significant increase over time in the mortality gap between patients with schizophrenia, and those with bipolar disorder, and the general population. Mortality rates in those under 65 with schizophrenia or bipolar disorder had been stable, which meant that they had not benefitted from the decline in mortality over time experienced in the general population within this age group. Mortality rates in those over 65 with these conditions had actually increased.
About three quarters of deaths were the result of natural causes, primarily circulatory and respiratory diseases.
The authors say they are encouraged that the UK government has recognised and prioritised the importance of preventing premature mortality in its recently published mental health strategy, but argue "there is a need for better understanding of the reasons for the persistent and increasing gap in mortality."And they call for "continued action to target risk factors for both natural and unnatural causes of death in people with serious mental illness."
An accompanying editorial says this study "serves as a resounding call to arms that inpatient psychiatric hospital admission provides a critical window to help tackle the increasing mortality gap in patients with serious mental illness and an essential step towards achieving the UK’s national mental health strategy."