Open AccessRisks of all‐cause and suicide mortality in mental disorders: a meta‐review
Author(s) -
Chesney Edward,
Goodwin Guy M.,
Fazel Seena
Publication year - 2014
Publication title -
world psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 15.51
H-Index - 93
eISSN - 2051-5545
pISSN - 1723-8617
DOI - 10.1002/wps.20128
Subject(s) - medicine , psychiatry , eating disorders , anorexia nervosa , population , depression (economics) , life expectancy , personality disorders , prevalence of mental disorders , bipolar disorder , meta analysis , poison control , systematic review , mental health , medline , personality , environmental health , psychology , social psychology , cognition , economics , macroeconomics , political science , law
A meta‐review, or review of systematic reviews, was conducted to explore the risks of all‐cause and suicide mortality in major mental disorders. A systematic search generated 407 relevant reviews, of which 20 reported mortality risks in 20 different mental disorders and included over 1.7 million patients and over a quarter of a million deaths. All disorders had an increased risk of all‐cause mortality compared with the general population, and many had mortality risks larger than or comparable to heavy smoking. Those with the highest all‐cause mortality ratios were substance use disorders and anorexia nervosa. These higher mortality risks translate into substantial (10‐20 years) reductions in life expectancy. Borderline personality disorder, anorexia nervosa, depression and bipolar disorder had the highest suicide risks. Notable gaps were identified in the review literature, and the quality of the included reviews was typically low. The excess risks of mortality and suicide in all mental disorders justify a higher priority for the research, prevention, and treatment of the determinants of premature death in psychiatric patients.