Serious Mental Illness and Mortality Rates

¹ Arizona Center for Clinical Management, 4575 East Broadway, Tucson, Arizona 85711
² University of Arizona School of Medicine in Tucson

As has been found in a variety of other studies, the mortality rate for the seriously mentally ill population was more than twice the mortality rate for individuals in a comparable general population. Furthermore, although the increased mortality rate for the seriously mentally ill population was not constant across all causes of death, it was at least double that of the general population in seven of eight categories. The difference was greater for unnatural causes of death than for natural causes (SMRs=4.4 and 1.7, respectively), with the rates of deaths related to HIV showing the largest difference (SMR=6.1). The only cause of death that showed a greater(but nonsignificantly greater) rate in the general population was neoplasms (SMR=O.6).

The finding that the seriously mentally ill population has a higher mortality rate than the general population is of less importance than is future research to identify the underlying reasons for this heightened mortality risk. This research is necessary before we can explore strategies to reduce mortality rates.

A variety of alternative explanations for the high mortality rate in the seriously mentally ill population are possible. The high rate of alcohol and other drug use in this population can result in an increased incidence of death by both natural causes, such as liver and cardiac problems, and unnatural causes, such as accidents, suicide, and homicide. Substance abuse can also be hypothesized to contribute to increased HIV risk. We are also aware that confounding factors associated with the consequences of serious mental illness might help explain the high mortality rate. Such factors include lower socioeconomic status and fewer natural supports, which in turn result in increased vulnerability and risk for morbidity.

However, it is clear that even if we were to prevent suicide in the most vulnerable of seriously mentally ill patients, the susceptibility of death from a variety of other causes would remain remarkably high.

This article has been cited by other articles:

				B. J. Miller, C. B. Paschall III, and D. P. Svendsen Mortality and Medical Comorbidity Among Patients With Serious Mental Illness Focus, January 1, 2008; 6(2): 239 - 245. [Abstract] [Full Text] [PDF]

				R. El-Mallakh, J. Zinner, A. Mackey, R. L. Tamas, C. M. Martin, J. Dalton, N. Dhaliwal, N. Luddington, F. U. Numan, R. Nunes, et al. Medical Decision-Making by Psychiatry Residents Acad Psychiatry, August 1, 2007; 31(4): 326 - 328. [Abstract] [Full Text] [PDF]

				L. Leas and M. Mccabe Health Behaviors among Individuals with Schizophrenia and Depression J Health Psychol, July 1, 2007; 12(4): 563 - 579. [Abstract] [PDF]

				B. J. Miller, C. B. Paschall III, and D. P. Svendsen Mortality and Medical Comorbidity Among Patients With Serious Mental Illness Psychiatr Serv, October 1, 2006; 57(10): 1482 - 1487. [Abstract] [Full Text] [PDF]

				C. R. Richardson, G. Faulkner, J. McDevitt, G. S. Skrinar, D. S. Hutchinson, and J. D. Piette Integrating Physical Activity Into Mental Health Services for Persons With Serious Mental Illness Psychiatr Serv, March 1, 2005; 56(3): 324 - 331. [Abstract] [Full Text] [PDF]

				C. Kennedy, P. Salsberry, J. Nickel, C. Hunt, and E. Chipps The Burden of Disease in Those With Serious Mental and Physical Illnesses Journal of the American Psychiatric Nurses Association, February 1, 2005; 11(1): 45 - 51. [Abstract] [PDF]

				J Neeleman A continuum of premature death. Meta-analysis of competing mortality in the psychosocially vulnerable Int. J. Epidemiol., February 1, 2001; 30(1): 154 - 162. [Abstract] [Full Text] [PDF]

				B. A. Golomb, J. M. Pyne, B. Wright, B. Jaworski, J. B. Lohr, and S. A. Bozzette The Role of Psychiatrists in Primary Care of Patients With Severe Mental Illness Psychiatr Serv, June 1, 2000; 51(6): 766 - 773. [Abstract] [Full Text] [PDF]

				B. P. Dembling, D. T. Chen, and L. Vachon Life Expectancy and Causes of Death in a Population Treated for Serious Mental Illness Psychiatr Serv, August 1, 1999; 50(8): 1036 - 1042. [Abstract] [Full Text] [PDF]

				W. H. Reid, M. Mason, and T. Hogan Suicide Prevention Effects Associated With Clozapine Therapy in Schizophrenia and Schizoaffective Disorder Psychiatr Serv, August 1, 1998; 49(8): 1029 - 1033. [Abstract] [Full Text]

Get information about faster international access.

Privacy Policy

Copyright © 1994 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us