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Premature mortality among people with severe mental illness — New evidence from linked primary care data

Marcos del Pozo Banos Orcid Logo, Ann John Orcid Logo, Joanna McGregor, Ian Jones, Sze Chim Lee, James T.R. Walters, Michael J. Owen, Michael O'Donovan, Marcos DelPozo-Banos, Damon Berridge, Keith Lloyd, Sze Chim Lee

Schizophrenia Research, Volume: 199, Pages: 154 - 162

Swansea University Authors: Marcos del Pozo Banos Orcid Logo, Ann John Orcid Logo, Sze Chim Lee

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DOI (Published version): 10.1016/j.schres.2018.04.009

Abstract

Studies assessing premature mortality in people with severe mental illness (SMI) are usually based in one setting, hospital (secondary care inpatients and/or outpatients) or community (primary care). This may lead to ascertainment bias. This study aimed to estimate standardised mortality ratios (SMR...

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Published in: Schizophrenia Research
ISSN: 09209964
Published: Elsevier 2018
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URI: https://cronfa.swan.ac.uk/Record/cronfa39476
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This may lead to ascertainment bias. This study aimed to estimate standardised mortality ratios (SMRs) for all-cause and cause-specific mortality in people with SMI drawn from linked primary and secondary care populations compared to the general population. SMRs were calculated using the indirect method for a United Kingdom population of almost four million between 2004-2013. The all-cause SMR was higher in the cohort identified from secondary care hospital admissions (SMR: 2.9; 95% CI: 2.8-3.0) than from primary care (SMR: 2.2; 95% CI: 2.1-2.3) when compared to the general population. The SMR for the combined cohort was 2.6 (95% CI: 2.5-2.6). Cause specific SMRs in the combined cohort were particularly elevated in those with SMI relative to the general population for ill-defined and unknown causes, suicide, substance abuse, Parkinson&#x2019;s disease, accidents, dementia, infections and respiratory disorders (particularly pneumonia), and Alzheimer&#x2019;s disease. Solely hospital admission based studies, which have dominated the literature hitherto, somewhat over-estimate premature mortality in those with SMI. People with SMI are more likely to die by ill-defined and unknown causes, suicide and other less common and often under-reported causes. Comprehensive characterisation of mortality is important to inform policy and practice and to discriminate settings to allow for proportionate interventions to address this health injustice.</abstract><type>Journal Article</type><journal>Schizophrenia Research</journal><volume>199</volume><paginationStart>154</paginationStart><paginationEnd>162</paginationEnd><publisher>Elsevier</publisher><issnPrint>09209964</issnPrint><keywords>Mortality, primary care, severe mental illness, schizophrenia, bipolar disorder</keywords><publishedDay>30</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2018</publishedYear><publishedDate>2018-09-30</publishedDate><doi>10.1016/j.schres.2018.04.009</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2020-06-18T13:25:02.3400859</lastEdited><Created>2018-04-18T15:38:28.3250323</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Marcos</firstname><surname>del Pozo Banos</surname><orcid>0000-0003-1502-389X</orcid><order>1</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>2</order></author><author><firstname>Joanna</firstname><surname>McGregor</surname><order>3</order></author><author><firstname>Ian</firstname><surname>Jones</surname><order>4</order></author><author><firstname>Sze Chim</firstname><surname>Lee</surname><order>5</order></author><author><firstname>James T.R.</firstname><surname>Walters</surname><order>6</order></author><author><firstname>Michael J.</firstname><surname>Owen</surname><order>7</order></author><author><firstname>Michael</firstname><surname>O'Donovan</surname><order>8</order></author><author><firstname>Marcos</firstname><surname>DelPozo-Banos</surname><order>9</order></author><author><firstname>Damon</firstname><surname>Berridge</surname><order>10</order></author><author><firstname>Keith</firstname><surname>Lloyd</surname><order>11</order></author><author><firstname>Sze Chim</firstname><surname>Lee</surname><order>12</order></author></authors><documents><document><filename>0039476-21092018112610.pdf</filename><originalFilename>39476.pdf</originalFilename><uploaded>2018-09-21T11:26:10.3170000</uploaded><type>Output</type><contentLength>672877</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><embargoDate>2018-09-19T00:00:00.0000000</embargoDate><documentNotes>Released under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0).</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2020-06-18T13:25:02.3400859 v2 39476 2018-04-18 Premature mortality among people with severe mental illness — New evidence from linked primary care data f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 10628af4988d624b49c4de7bd78b4694 Sze Chim Lee Sze Chim Lee true false 2018-04-18 HDAT Studies assessing premature mortality in people with severe mental illness (SMI) are usually based in one setting, hospital (secondary care inpatients and/or outpatients) or community (primary care). This may lead to ascertainment bias. This study aimed to estimate standardised mortality ratios (SMRs) for all-cause and cause-specific mortality in people with SMI drawn from linked primary and secondary care populations compared to the general population. SMRs were calculated using the indirect method for a United Kingdom population of almost four million between 2004-2013. The all-cause SMR was higher in the cohort identified from secondary care hospital admissions (SMR: 2.9; 95% CI: 2.8-3.0) than from primary care (SMR: 2.2; 95% CI: 2.1-2.3) when compared to the general population. The SMR for the combined cohort was 2.6 (95% CI: 2.5-2.6). Cause specific SMRs in the combined cohort were particularly elevated in those with SMI relative to the general population for ill-defined and unknown causes, suicide, substance abuse, Parkinson’s disease, accidents, dementia, infections and respiratory disorders (particularly pneumonia), and Alzheimer’s disease. Solely hospital admission based studies, which have dominated the literature hitherto, somewhat over-estimate premature mortality in those with SMI. People with SMI are more likely to die by ill-defined and unknown causes, suicide and other less common and often under-reported causes. Comprehensive characterisation of mortality is important to inform policy and practice and to discriminate settings to allow for proportionate interventions to address this health injustice. Journal Article Schizophrenia Research 199 154 162 Elsevier 09209964 Mortality, primary care, severe mental illness, schizophrenia, bipolar disorder 30 9 2018 2018-09-30 10.1016/j.schres.2018.04.009 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2020-06-18T13:25:02.3400859 2018-04-18T15:38:28.3250323 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Marcos del Pozo Banos 0000-0003-1502-389X 1 Ann John 0000-0002-5657-6995 2 Joanna McGregor 3 Ian Jones 4 Sze Chim Lee 5 James T.R. Walters 6 Michael J. Owen 7 Michael O'Donovan 8 Marcos DelPozo-Banos 9 Damon Berridge 10 Keith Lloyd 11 Sze Chim Lee 12 0039476-21092018112610.pdf 39476.pdf 2018-09-21T11:26:10.3170000 Output 672877 application/pdf Version of Record true 2018-09-19T00:00:00.0000000 Released under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0). true eng
title Premature mortality among people with severe mental illness — New evidence from linked primary care data
spellingShingle Premature mortality among people with severe mental illness — New evidence from linked primary care data
Marcos del Pozo Banos
Ann John
Sze Chim Lee
title_short Premature mortality among people with severe mental illness — New evidence from linked primary care data
title_full Premature mortality among people with severe mental illness — New evidence from linked primary care data
title_fullStr Premature mortality among people with severe mental illness — New evidence from linked primary care data
title_full_unstemmed Premature mortality among people with severe mental illness — New evidence from linked primary care data
title_sort Premature mortality among people with severe mental illness — New evidence from linked primary care data
author_id_str_mv f141785b1c0ab9efe45665d35c081b84
ed8a9c37bd7b7235b762d941ef18ee55
10628af4988d624b49c4de7bd78b4694
author_id_fullname_str_mv f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
10628af4988d624b49c4de7bd78b4694_***_Sze Chim Lee
author Marcos del Pozo Banos
Ann John
Sze Chim Lee
author2 Marcos del Pozo Banos
Ann John
Joanna McGregor
Ian Jones
Sze Chim Lee
James T.R. Walters
Michael J. Owen
Michael O'Donovan
Marcos DelPozo-Banos
Damon Berridge
Keith Lloyd
Sze Chim Lee
format Journal article
container_title Schizophrenia Research
container_volume 199
container_start_page 154
publishDate 2018
institution Swansea University
issn 09209964
doi_str_mv 10.1016/j.schres.2018.04.009
publisher Elsevier
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Studies assessing premature mortality in people with severe mental illness (SMI) are usually based in one setting, hospital (secondary care inpatients and/or outpatients) or community (primary care). This may lead to ascertainment bias. This study aimed to estimate standardised mortality ratios (SMRs) for all-cause and cause-specific mortality in people with SMI drawn from linked primary and secondary care populations compared to the general population. SMRs were calculated using the indirect method for a United Kingdom population of almost four million between 2004-2013. The all-cause SMR was higher in the cohort identified from secondary care hospital admissions (SMR: 2.9; 95% CI: 2.8-3.0) than from primary care (SMR: 2.2; 95% CI: 2.1-2.3) when compared to the general population. The SMR for the combined cohort was 2.6 (95% CI: 2.5-2.6). Cause specific SMRs in the combined cohort were particularly elevated in those with SMI relative to the general population for ill-defined and unknown causes, suicide, substance abuse, Parkinson’s disease, accidents, dementia, infections and respiratory disorders (particularly pneumonia), and Alzheimer’s disease. Solely hospital admission based studies, which have dominated the literature hitherto, somewhat over-estimate premature mortality in those with SMI. People with SMI are more likely to die by ill-defined and unknown causes, suicide and other less common and often under-reported causes. Comprehensive characterisation of mortality is important to inform policy and practice and to discriminate settings to allow for proportionate interventions to address this health injustice.
published_date 2018-09-30T03:50:08Z
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