Excess mortality of mental disorder

1998 ◽  
Vol 173 (1) ◽  
pp. 11-53 ◽  
Author(s):  
Clare Harris ◽  
Brian Barraclough
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
English Language ◽  
Common Mental Disorders ◽  
Premature Death ◽  
Medline Search ◽  
Risk Of Death ◽  
Increased Risk ◽  
Standardised Mortality Ratios ◽  
The Common

BackgroundWe describe the increased risk of premature death from natural and from unnatural causes for the common mental disorders.MethodWith a Medline search (1966–1995) we found 152 English language reports on the mortality of mental disorder which met our inclusion criteria. From these reports, covering 27 mental disorder categories and eight treatment categories, we calculated standardised mortality ratios (SMRs) and 95% confidence intervals (CIs) for all causes of death, all natural causes and all unnatural causes; and for most, SMRs for suicide, other violent causes and specific natural causes.ResultsHighest risks of premature death, from both natural and unnatural causes, are for substance abuse and eating disorders. Risk of death from unnatural causes is especially high for the functional disorders, particularly schizophrenia and major depression. Deaths from natural causes are markedly increased for organic mental disorders, mental retardation and epilepsy.ConclusionAll mental disorders have an increased risk of premature death.

Suicide as an outcome for mental disorders

1997 ◽  
Vol 170 (3) ◽  
pp. 205-228 ◽  
Author(s):  
E. Clare Harris ◽  
Brian Barraclough
Keyword(s):  
Mental Disorders ◽  
Suicide Risk ◽  
English Language ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Strong Association ◽  
Search Terms ◽  
Increased Risk ◽  
Mortality Ratio

BackgroundMental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders.MethodWe searched the medical literature to find reports on the mortality of mental disorders. English language reports were located on MEDLINE (1966–1993) with the search terms mental disorders', ‘brain injury’, ‘eating disorders’, ‘epilepsy’, ‘suicide attempt’, ‘psychosurgery’, with ‘mortality’ and ‘follow-up studies’, and from the reference lists of these reports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suicides with those expected. A standardised mortality ratio (SMR) was calculated for each disorder.ResultsOf 44 disorders considered, 36 have a significantly raised SMR for suicide, five have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated.ConclusionsIf these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide risk is highest for functional and lowest for organic disorders with substance misuse disorders lying between. However, within these broad groupings the suicide risk varies widely.

scholarly journals Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries

2020 ◽  
Vol 29 ◽  
Author(s):  
J. J. McGrath ◽  
C. C. W. Lim ◽  
O. Plana-Ripoll ◽  
Y. Holtz ◽  
E. Agerbo ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Proportional Hazards ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Epidemiological Studies ◽  
Cox Proportional Hazards ◽  
Comprehensive Analysis ◽  
Diverse Range ◽  
Increased Risk

Abstract Aims Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys. Methods The WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women. Results Each prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2–110.8, interquartile range = 6.0–19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1–2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs. Conclusions Survey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.

scholarly journals AB0393 PRE-EXISTING MORBIDITY AS A RISK FACTORS FOR MORTALITY IN IgA VASCULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1224.3-1225
Author(s):  
J. Nossent ◽  
D. Preen ◽  
W. Raymond ◽  
H. Keen ◽  
C. Inderjeeth
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Mortality Rate ◽  
Data Collection ◽  
Premature Death ◽  
Iga Vasculitis ◽  
Risk Of Death ◽  
Increased Risk ◽  
Serious Infections ◽  
Western Australian

Background:IgA vasculitis is generally considered to be a self-limiting condition, but this is at odds with the increased mortality observed in adult patients with IgA vasculitis (1).Objectives:With sparse data on prognostic factors in IgAV, we investigated whether pre-existing conditions are risk factors for mortality in adult IgAV patients.Methods:Observational population-based cohort study using state-wide linked longitudinal health data for adults with IgAV (n=267) and matched controls (n=1080) between 1980-2015. Charlson comorbidity index (CCI) and serious infections (SI) were recorded over an extensive lookback period prior to diagnosis. Date and causes of death were extracted from the WA Death Registry. Mortality rate (deaths/1000 person-years) ratios (MRR) and time dependent survival analysis assessed the risk of death. Age and gender specific mortality rate data were obtained from the Australian Bureau of Statistics.Results:During 9.9 (±9.8) years lookback IgAV patients accrued higher CCI scores (2.60 vs1.50 p<0.001) and had higher risk of SI (OR 8.4, p<0.001), not fully explained by CCI scores. During 19 years follow-up, the risk of death in IgAV patients (n=137) was higher than in controls (n=397) (MRR 2.06, CI 1.70-2.50, p<0.01) and the general population (SMRR 5.64, CI 4.25, 7.53, p<0.001). Survival in IgAV was reduced at five (72.7 vs. 89.7 %) and twenty years (45.2% vs. 65.6 %) (both p<0.05). CCI (HR1.88, CI:1.25 - 2.73, p=0.001), renal failure (HR 1.48, CI: 1.04 - 2.22, p=0.03) and prior SI (HR 1.48, CI:1.01 – 2.16, p=0.04) were independent risk factors. Death from infections (5.8 vs 1.8%, p=0.02) was significantly more frequent in IgAV patients.Conclusion:Premorbid accrual of comorbidity is increased and predicts premature death in IgAV patients. However, comorbidity does not fully explain the increased risk of serious infections prior to diagnosis or the increased mortality due to infections in IgAV.References:[1]Villatoro-Villar M, Crowson CS, Warrington KJ, Makol A, Ytterberg SR, Koster MJ. Clinical Characteristics of Biopsy-Proven IgA Vasculitis in Children and Adults: A Retrospective Cohort Study. Mayo Clin Proc. 2019;94(9):1769-80.Acknowledgements:The authors would like to acknowledge the support of the Arthritis Foundation of WA and acknowledge the Western Australian Data Linkage Branch, the Western Australian Department of Health, and the data custodians of, the Hospital and Morbidity Data Collection, the Emergency Department Data Collection the WA Cancer Register and the WA Death Register for their assistance with the study.Disclosure of Interests:None declared

scholarly journals Associations between common mental disorders and the Mental Illness Needs Index in community settings

2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Small Area ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Service Planning ◽  
Individual Risk ◽  
Community Settings

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.

scholarly journals Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Sebastião Viola ◽  
Joanna Moncrieff
Keyword(s):  
Anxiety Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Disability Benefits ◽  
Common Cause ◽  
Individual Support ◽  
Government Data ◽  
The Uk

BackgroundThere is international concern about the levels of sickness and disability benefits, with mental disorders known to account for a large proportion of claims.AimsTo examine trends in sickness and disability benefits awarded for mental disorders in the UK.MethodThe researchers analysed UK Government data from 1995 to 2014.ResultsMental disorders have become the most common cause of receiving benefits, with the number of claimants rising by 103% from 1995 to 1.1 million in 2014. Claimants with other conditions fell by 35%. In 2014, 47% of claims were attributed to a mental disorder. The number of long-term claimants (claiming over 5 years) with mental disorders increased by 87% from 2000 to 2011. Two-thirds of mental disorder claimants were classified as having a depressive or anxiety disorder.ConclusionsCommon mental disorders may involve greater morbidity and social costs than usually recognised. Availability of suitable employment, as well as individual support, may be necessary to reduce benefit levels.

scholarly journals The Meaning of Comorbidity Among Common Mental Disorders

2020 ◽  
Author(s):  
Nicholas R Eaton ◽  
Susan Carol South ◽  
Robert Krueger
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Factor Model ◽  
Common Mental Disorders

An overview of different models of mental disorder comorbidity and an early review of the transdiagnostic factor model of comorbidity (e.g., internalizing-externalizing).

Prevalence and determinants of Common Mental Disorder among pregnant women In Debre Berhan town: Highland in Central Ethiopia

2020 ◽  
Author(s):  
Kefyalew Dagne Gizachew ◽  
Gashaw Andargie Biks ◽  
Abate Dargie Wubetu
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Pregnant Women ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Significant Risk ◽  
Medical Illness ◽  
Debre Berhan ◽  
Self Reporting Questionnaire

Abstract Introduction: The high prevalence of antenatal mental disorders in Sub-Saharan African countries is poorly understood. Pregnancy and childbirth are gaining recognition as significant risk factors for the development and exacerbation of mental health problems. In low- and lower-middle income countries about one in six pregnant women are experiencing antenatal common mental disorders (CMD). Objective: To assess prevalence and associated factors of common mental disorders (CMD) among pregnant women in Debre Berhan town, North Showa Zone, Amhara region, Ethiopia, 2016. Methods: Community based cross-sectional study was employed among 569 participants. Data was collected using face-to-face interviews with Amharic version of Self Reporting Questionnaire (SRQ-20) from seven selected kebeles. Kebeles were selected by simple random sampling and individuals were selected using cluster sampling. Crude and adjusted OR was analyzed using bivariate and multivariable logistic regression analysis and the level of significance for association was determined with 95% CI and at P- value < 0.05. Result: A total 557 study participants were completed the interview and the prevalence of antenatal common mental disorder was found to be 45.2%. Loss of loved one (AOR = 1.97; 95% CI: 1.19–3.27), history of chronic medical illness (AOR = 6.57; 95% CI: 2.17–19.94), unwanted pregnancy (AOR = 2.13; 95% CI: 1.15–3.95), nulliparity (AOR = 8.71; 95% CI: 1.58–47.94), one or less ANC consultations (AOR = 0.22; 95% CI: 0.08–0.64), two-three ANC consultations (AOR = 0.30; 95% CI: 0.11–0.83) and current obstetric complications (AOR = 4.45; 95% CI: 2.21–8.99) were important factors significantly associated with antenatal common mental disorder. Conclusion: The prevalence of antenatal common mental disorder (CMD) was high in this study that shows antenatal CMD is significant public health issue that requires a great emphasis. So, early screening and intervention for antenatal CMD should be integrated in primary health care and antenatal care service settings.

scholarly journals Interaction between demand-control and social support in the occurrence of common mental disorders

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Amália Ivine Santana Mattos ◽  
Tânia Maria de Araújo ◽  
Maura Maria Guimarães de Almeida
Keyword(s):  
Social Support ◽  
Mental Disorders ◽  
Health Workers ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
High Demand ◽  
Cross Sectional ◽  
High Social Support ◽  
The Common ◽  
Demand Control

ABSTRACT OBJECTIVE To analyze the interaction between the psychosocial aspects of work and the occurrence of common mental disorders among health workers. METHODS This is a cross-sectional study conducted with a representative sample of workers of the primary health care of five municipalities of the State of Bahia, Brazil, in 2012. The variable of outcome were the common mental disorders evaluated by the SRQ-20, and the variables of exposure were high demand (high psychological demand and low control over the work) and low social support in the workplace. Interaction was checked by the deviation of the additivity of the effects for the factors studied from the calculation of excess risk from interaction, proportion of cases attributed to interaction, and the synergy index. RESULTS The global prevalence of common mental disorders was 21%. The group of combined exposure has shown higher magnitude (high demand and low social support), reaching 28% when compared to the 17% in the situation of no exposure (low demand and high social support). CONCLUSIONS The results strengthen the hypothesis of interaction between the factors investigated, directing to the synergy of the effects.

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