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Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register

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Abstract

Purpose

People with mental disorders show mortality rates up to 22.2 times higher than that of the general population. In spite of progressive increase in life expectancy observed in the general population, the mortality gap of people suffering from mental health problems has gradually widened. The aim of this paper was to study mortality rates in people suffering from mental illness in a cohort of people (16,981 subjects) in the local mental health register of the province of Modena during the decade 2006–2015.

Methods

Standardized Mortality Ratios (SMRs) were calculated to compare the mortality of people with mental disorders to the mortality of people living in the province of Modena and the excess of mortality was studied in relation to the following variables: gender, age group, diagnosis and causes of death. In addition, Poisson regression analysis was performed to study the association between patient characteristics and mortality.

Results

An overall excess mortality of 80% was found in subjects under the care of mental health services as compared to the reference population (SMR = 1.8, 95% CI 1.7–1.9). Subjects in the 15–44 year group presented the highest SMR (9.2, 95% CI 6.9–11.4). The most prevalent cause of death was cancer (28.1% of deaths). At the Poisson regression, the diagnosis “Substance abuse and dependence” showed the highest relative risk (RR) (4.00). Moreover, being male, single, unemployed and with a lower qualification was associated with higher RRs.

Conclusions

Our study confirms that subjects with mental illness have higher SMR. Noteworthy, the overall higher risk of mortality was observed in the younger age group.

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Authors and Affiliations

  1. Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy

    Fabrizio Starace, Francesco Mungai & Flavia Baccari

  2. Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università degli Studi di Modena e Reggio Emilia, Modena, Italy

    Gian Maria Galeazzi

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  1. Fabrizio Starace
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  2. Francesco Mungai
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Correspondence to Francesco Mungai.

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The authors declare that there is no conflict of interest regarding the publication of this paper.

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Ethical approval was not required as this study was performed as secondary data analysis on anonymous datasets.

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Starace, F., Mungai, F., Baccari, F. et al. Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register. Soc Psychiatry Psychiatr Epidemiol 53, 249–257 (2018). https://doi.org/10.1007/s00127-017-1468-8

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