Premium
Natural cause mortality in persons with serious mental illness
Author(s) -
Dickerson F.,
Origoni A.,
Schroeder J.,
Adamos M.,
Katsafanas E.,
Khushalani S.,
Savage C. L. G.,
Schweinfurth L. A. B.,
Stallings C.,
Sweeney K.,
Yolken R.
Publication year - 2018
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12880
Subject(s) - medicine , relative risk , population , cohort , cohort study , confidence interval , environmental health
Objective To identify the determinants of natural cause mortality in a cohort of individuals with serious mental illness assessed prospectively. Method Persons with schizophrenia ( n = 789) and bipolar disorder ( n = 498), mean age of 38 (s.d. 12.6) years, underwent an in‐person clinical assessment. They also had a blood sample drawn from which infectious disease markers were measured. Mortality was subsequently determined utilizing data from the National Death Index following a period of up to 16.9 years. Results A total of 6.8% (87 of 1287) of persons died of natural causes. Mortality was predicted in a multivariate model by baseline cigarette smoking (RR = 6.29, 95% CI 1.41, 3.72, P = 0.00076); divorced or widowed status (RR = 1.90, CI 1.21, 2.99); reduced cognitive score (RR = 0.73, CI 0.61, 0.87); receipt of antidepressant medication (RR = 1.74, CI 1.12, 2.71); elevated levels of antibodies to Epstein–Barr virus (EBV) (RR = 1.29, CI 1.01, 1.66); and a genitourinary (RR = 1.82, CI 1.16, 2.86), respiratory (RR = 1.82, CI 1.16, 2.86), or cardiac (RR = 2.09, CI 1.33, 3.29) condition. There was an additive effect of smoking and both a cardiac and a respiratory condition but not elevated EBV antibody levels. Conclusion Smoking is a modifiable behaviour which is associated with mortality in this population.