Mental illness can take years off someone's life, but maybe not as many as has been previously thought.  Recent research shows that serious and persistent mental illness can result in a person's losing up to four years of their life compared to people without mental illness.[1]

Dr. Elizabeth E. Piatt from the Department of Behaviors and Community Health Services at Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, and her colleagues, examined the death records of patients from a community mental health center as well as from the general population.  These researchers found an increase in premature mortality in the mentally ill patients – not only from suicide – but also accidents, cancer, liver disease and septicemia.

“We found that a community-based sample of adults with severe and persistent mental illness lost 14.5 years of potential life, a difference of 4.2 years from the (control) sample,” said Piatt.

For years, it has been known that people with severe psychiatric illness have shorter lifespans (thought to be from 13.5 to 32 years shorter).  More than 90 percent of suicides are as a result of a mental illness.[2] People with untreated bipolar disorder, for instance, are predicted to have a mortality rate of 20% from suicide.[3] 

However, recent research has made it clear that there is an increased mortality in patients with mental illness not directly explained by mental health issues, but related to general medical problems.

Most studies have tended to focus only on inpatients.  Additionally, previous research has not directly compared the years of potential life lost between patients with mental health issues and  those without mental illness.  Thus the number of potential years of life lost may actually be lower than previously suggested.

“By not examining differences in premature mortality, the results of these studies may have overestimated (this outcome) in the population with serious mental illness,” note the authors.

To assess accurately the true impact of persistent and serious mental illness on years of potential life lost, Piatt and her colleagues retrospectively matched 647 case management files from patients treated at a community health center before their deaths to 15,517 state death records from the general population.

The researchers found that the mean number of years of potential life lost for decedents with serious and persistent mental illness was 14.5 compared to 10.5 for the general population.  The mean age of death for the psychiatric patients was 73.4 years compared to 79.6 years.

Heart disease was the leading cause of death for each group, although there were differences seen in every leading cause of death. 

“Differences in cause of death did not explain the difference in years of potential life lost,” said Piatt.

Psychiatric patients are possibly more likely to engage in risky behaviors that result in accidents, or to smoke, or to be less compliant with medications. Another recent study showed that patients with bipolar disorder are at an increased risk for heart disease. 

Other research has shown that patients admitted to psychiatric hospitals are at risk for increased mortality from general medical problems. Also, some psychiatric medications (especially antipsychotics), can increase the risk of heart disease and/or diabetes.

The authors conclude: “Our work adds to the growing body of literature that highlights the need for better preventative health care for persons with mental illness.  Along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on these preventable causes of death.”

Dr. Piatt’s results are published in the July issue of Psychiatric Services.

 


[1] http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness/15502.html

[2] Ibid

[3] National Institute on Mental Health (NIMH); www.nimh.nih.gov