TY - JOUR
T1 - Natural cause mortality in persons with serious mental illness
AU - Dickerson, F.
AU - Origoni, A.
AU - Schroeder, J.
AU - Adamos, M.
AU - Katsafanas, E.
AU - Khushalani, S.
AU - Savage, C. L.G.
AU - Schweinfurth, L. A.B.
AU - Stallings, C.
AU - Sweeney, K.
AU - Yolken, R.
N1 - Funding Information:
This work was supported by the Stanley Medical Research Institute (07R-1690 to FD).
Publisher Copyright:
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2018/5
Y1 - 2018/5
N2 - 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.
AB - 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.
KW - bipolar disorder
KW - mortality
KW - schizophrenia
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U2 - 10.1111/acps.12880
DO - 10.1111/acps.12880
M3 - Article
C2 - 29603145
AN - SCOPUS:85044613015
SN - 0001-690X
VL - 137
SP - 371
EP - 379
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
IS - 5
ER -