People with serious mental illness lose significantly more years of potential life than the general population, according to research presented in the July issue of Psychiatric Services, a journal of the American Psychiatric Association. Years of potential life lost, or YPLL, which is based on U.S. life expectancy in the year of death, is a widely used measure of premature mortality.

The study compared the death records of 647 Akron, Ohio, residents who had been receiving services for serious and persistent mental illness at a community mental health center and 15,517 residents in the general population of Akron. The people with serious mental illness lost 14.5 years of potential life, with an average age at death of 73.4 years, while the other residents lost 10.3 years of potential life, and died at an average age of 79.6 years. Heart disease was the leading cause of death for both groups. Premature mortality among persons with serious mental illness was increased by cancer, liver disease, and septicemia. Those with psychiatric disorders were also more likely to die from unnatural causes, such as suicide, accidents, and assault.

While it is well established that people with serious mental illness die much sooner that those without, this study looked specifically at years of potential life lost after adjusting for sociodemographic factors and cause of death. Factors such as gender, race/ethnicity, education, and marital status were related to premature mortality, but did not account for the difference in years of potential life lost between the two groups of Akron residents. In addition, most previous studies looked at deaths among samples of hospitalized psychiatric patients, who would be expected to be more ill than patients living in the community. However, even in this healthier sample, the study found a significant degree of premature mortality.

The researchers concluded that along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on the preventable causes of early death. The authors also noted that the concept of every patient's having a mental health care home- integrating mental health care, primary health care, and wellness promotion-holds great promise and may help to reduce the causes of preventable early death.

The researchers, all affiliated with Northeastern Ohio University College of Medicine and Pharmacy, included Elizabeth E. Piatt, Ph.D., Mark R. Munetz, M.D., and Christian Ritter, Ph.D.

Source:
American Psychiatric Association