scholarly journals Contributions of specific causes of death to lost life expectancy in severe mental illness

2017 ◽  
Vol 43 ◽  
pp. 109-115 ◽  
Author(s):  
N. Jayatilleke ◽  
R.D. Hayes ◽  
R. Dutta ◽  
H. Shetty ◽  
M. Hotopf ◽  
...  

AbstractThe life expectancy gap between people with severe mental illness (SMI) and the general population persists and may even be widening. This study aimed to estimate contributions of specific causes of death to the gap. Age of death and primary cause of death were used to estimate life expectancy at birth for people with SMI from a large mental healthcare case register during 2007–2012. Using data for England and Wales in 2010, death rates in the SMI cohort for each primary cause of death category were replaced with gender- and age-specific norms for that cause. Life expectancy in SMI was then re-calculated and, thus, the contribution of that specific cause of death estimated. Natural causes accounted for 79.2% of lost life-years in women with SMI and 78.6% in men. Deaths from circulatory disorders accounted for more life-years lost in women than men (22.0% versus 17.4%, respectively), as did deaths from cancer (8.1% versus 0%), but the contribution from respiratory disorders was lower in women than men (13.7% versus 16.5%). For women, cancer contributed more in those with non-affective than affective disorders, while suicide, respiratory and digestive disorders contributed more in those with affective disorders. In men, respiratory disorders contributed more in non-affective disorders. Other contributions were similar between gender and affective/non-affective groups. Loss of life expectancy in people with SMI is accounted for by a broad range of causes of death, varying by gender and diagnosis. Interventions focused on multiple rather than individual causes of death should be prioritised accordingly.

2019 ◽  
Vol 9 ◽  
pp. 244
Author(s):  
Fernando Flores Santos Ribeiro ◽  
Eliane Menezes Flores Santos ◽  
André Renê Barboni

Foi levantado e analisado o impacto de algumas causas de morte na esperança de vida (EV) dos residentes dos bairros centrais e periféricos de São Paulo (capital), 2000 e 2010. Analisou-se a importância dos grupos de causas de óbito na EV, utilizando-se tábuas de vida e a teoria de riscos competitivos. os cinco capítulos da CiD10 analisados abrangem mais de três quartos dos óbitos, em ambos os sexos, nos anos estudados. Nota-se uma clara tendência de envelhecimento de ambas as regiões. A diferença da Esperança de Vida ao Nascer (EVN) entre mulheres e homens do centro e da periferia diminuiu, mas a disparidade entre áreas aumentou. A análise dos Anos Potenciais de Vida Ganhos, através da eliminação do risco de morrer por alguns grupos de causa de morte, mostra diferenças em função da importância relativa que cada grupo tem em cada uma das populações e permite ao gestor estabelecer uma política mais específica e resolutiva que certamente irá se refletir na qualidade de vida. Fica claro que existem duas realidades muito diferentes dentro do mesmo município. Provavelmente isso também é válido para o restante do Brasil.AbstractThe study analyzed the impact of some causes of death in the life expectancy of the central and peripheral districts residents of São Paulo (capital city), 2000 and 2010. the importance of the groups of causes of death was measured by life tables and the theory of competitive risks. The five chapters of ICD10 analyzed cover more than three quarters of deaths in both sexes. there was a clear trend towards aging in both regions. The difference in Life Expectancy at Birth between women and men in the center and the periphery decreased, but the disparity between areas increased. the analysis of the Potential Life Years Earnings by eliminating the risk of dying by some cause of death groups shows differences depending on the relative importance that each group has in each of the populations and allows the manager to establish a more specific policy, which will certainly be reflected in the quality of life. It is clear that there are two very different realities within the same city. This is probably also true for the rest of Brazil


PLoS ONE ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. e19590 ◽  
Author(s):  
Chin-Kuo Chang ◽  
Richard D. Hayes ◽  
Gayan Perera ◽  
Mathew T. M. Broadbent ◽  
Andrea C. Fernandes ◽  
...  

Author(s):  
Anne Høye ◽  
Bjarne K. Jacobsen ◽  
Jørgen G. Bramness ◽  
Ragnar Nesvåg ◽  
Ted Reichborn-Kjennerud ◽  
...  

Abstract Purpose To investigate the mortality in both in- and outpatients with personality disorders (PD), and to explore the association between mortality and comorbid substance use disorder (SUD) or severe mental illness (SMI). Methods All residents admitted to Norwegian in- and outpatient specialist health care services during 2009–2015 with a PD diagnosis were included. Standardized mortality ratios (SMRs) with 95% confidence intervals (CI) were estimated in patients with PD only and in patients with PD and comorbid SMI or SUD. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs in patients with PD and comorbid SMI or SUD compared to patients with PD only. Results Mortality was increased in both in- and outpatients with PD. The overall SMR was 3.8 (95% CI 3.6–4.0). The highest SMR was estimated for unnatural causes of death (11.0, 95% CI 10.0–12.0), but increased also for natural causes of death (2.2, 95% CI 2.0–2.5). Comorbidity was associated with higher SMRs, particularly due to poisoning and suicide. Patients with comorbid PD & SUD had almost four times higher all-cause mortality HR than patients with PD only; young women had the highest HR. Conclusion The SMR was high in both in- and outpatients with PD, and particularly high in patients with comorbid PD & SUD. Young female patients with PD & SUD were at highest risk. The higher mortality in patients with PD cannot, however, fully be accounted for by comorbidity.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, <1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.


Author(s):  
Bal Kishan Gulati ◽  
Damodar Sahu ◽  
Anil Kumar ◽  
M. V. Vardhana Rao

Background: Life expectancy is a statistical measure to depict average life span a person is expected to live at a given age under given age-specific mortality rates. Cause-elimination life table measures potential gain in life expectancy after elimination of a specific disease. The present study aims to estimate potential gain in life expectancy by gender in urban India after complete and partial elimination of ten leading causes of deaths using secondary data of medical certification of cause of death (MCCD) for the year 2015.Methods: Life table method was used for estimating potential gain after eliminating diseases to the tune of 25%, 50%, 75% and 100%.Results: Maximum gain in life expectancy at birth estimated from complete elimination of diseases of the circulatory system (11.1 years in males versus 13.1 years in females); followed by certain infectious and parasitic diseases (2.2  versus 2.1 years); diseases of the respiratory system (2.2 versus 2.1); injury, poisoning and certain other consequences of external causes (1.1 versus 0.7); neoplasms (0.9 versus 1.0); endocrine, nutritional and metabolic diseases (0.8 versus 0.9); diseases of the digestive system (0.8 versus 0.4); diseases of the genitourinary system (0.6 versus 0.6); diseases of the nervous system (0.4 versus 0.4); and diseases of blood & blood forming organs and certain disorders involving the immune mechanism (0.2 versus 0.3 years).Conclusions: Elimination of the circulatory diseases resulted into maximum gain in life expectancy. These findings may have implications in setting up health goals, allocating resources and launching tailor-made health programmes.


2001 ◽  
Vol 28 (1) ◽  
pp. 89 ◽  
Author(s):  
Frank Trovato ◽  
N. M. Lalu

A number of industrialized nations have recently experienced some degrees of constriction in their long-standing sex differentials in life expectancy at birth. In this study we examine this phenomenon in the context of Canada’s regions between 1971 and 1991: Atlantic (Newfoundland, Nova Scotia, New Brunswick, Prince Edward Island); Quebec, Ontario, and the West (Manitoba, Saskatchewan, Alberta, British Columbia, Yukon and Northwest Territories). Decomposition analysis based on multiple decrement life tables is applied to address three questions: (1) Are there regional differentials in the degree of narrowing in the sex gap in life expectancy? (2) What is the relative contribution of major causes of death to observed sex differences in average length of life within and across regions? (3) How do the contributions of cause-of-death components vary across regions to either widen or narrow the sex gap in survival? It is shown that the magnitude of the sex gap is not uniform across the regions, though the differences are not large. The most important contributors to a narrowing of the sex gap in life expectancy are heart disease and external types of mortality (i.e., accidents, violence, and suicide), followed by lung cancer and other types of chronic conditions. In substantive terms these results indicate that over time men have been making sufficient gains in these causes of death as to narrow some of the gender gap in overall survival. Regions show similarity in these effects.


2019 ◽  
Vol 8 (5) ◽  
pp. 586 ◽  
Author(s):  
Silvia Amoretti ◽  
Bibiana Cabrera ◽  
Carla Torrent ◽  
Caterina del Mar Bonnín ◽  
Gisela Mezquida ◽  
...  

(1) Background: The cognitive reserve (CR) concept has not been precisely defined in severe mental disorders and has been estimated using heterogeneous methods. This study aims to investigate and develop the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH), an instrument designed to measure CR in people with severe mental illness; (2) Methods: 100 patients with severe mental illness (non-affective psychoses and affective disorders) and 66 healthy controls were included. The internal consistency and convergent validity of CRASH were assessed. Spearman’s correlations coefficients were also performed to examine the relationship between CRASH and neuropsychological tests, psychosocial functioning, and clinical course; (3) Results: The internal consistency was high (Cronbach’s alpha coefficient = 0.903). The CRASH global score had a large positive correlation with the Cognitive reserve questionnaire total score (r = 0.838, p < 0.001), demonstrating good convergent validity. The correlation coefficients between the CRASH total scores and clinical, functional, and neuropsychological performance were different between groups. In order to provide clinical interpretation, severity classification based on diagnosis (non-affective psychotic disorders, affective disorders, and healthy controls) have been created; (4) Conclusions: CRASH is the first CR measure developed specifically for patients with severe mental illness, facilitating reliable and valid measurement of this construct. The scale may aid in the stratification of patients and the implementation of personalized interventions.


2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Julie Langan Martin ◽  
Gary McLean ◽  
John Park ◽  
Daniel J Martin ◽  
Moira Connolly ◽  
...  

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e018181 ◽  
Author(s):  
Ella Zomer ◽  
David Osborn ◽  
Irwin Nazareth ◽  
Ruth Blackburn ◽  
Alexandra Burton ◽  
...  

ObjectivesTo determine the cost-effectiveness of two bespoke severe mental illness (SMI)-specific risk algorithms compared with standard risk algorithms for primary cardiovascular disease (CVD) prevention in those with SMI.SettingPrimary care setting in the UK. The analysis was from the National Health Service perspective.Participants1000 individuals with SMI from The Health Improvement Network Database, aged 30–74 years and without existing CVD, populated the model.InterventionsFour cardiovascular risk algorithms were assessed: (1) general population lipid, (2) general population body mass index (BMI), (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those considered high risk (>10%) were assumed to be prescribed statin therapy while others received usual care.Primary and secondary outcome measuresQuality-adjusted life years (QALYs) and costs were accrued for each algorithm including no algorithm, and cost-effectiveness was calculated using the net monetary benefit (NMB) approach. Deterministic and probabilistic sensitivity analyses were performed to test assumptions made and uncertainty around parameter estimates.ResultsThe SMI-specific BMI algorithm had the highest NMB resulting in 15 additional QALYs and a cost saving of approximately £53 000 per 1000 patients with SMI over 10 years, followed by the general population lipid algorithm (13 additional QALYs and a cost saving of £46 000).ConclusionsThe general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of an SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings.


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