Association between mental disorders and mortality: A register-based cohort study from the region of Catalonia. (February 2023)

• Record Type: Journal Article
• Authors: Olaya, Beatriz; Moneta, Maria Victoria; Plana-Ripoll, Oleguer; Haro, Josep Maria
• Is Part Of: Psychiatry research. Volume 320(2023)
• Publication Date: 2023-02
• Subjects: Standardised mortality rate -- Psychotic disorders -- Bipolar disorders -- Major depressive disorders -- Anxiety disorders -- Natural and unnatural causes; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2022.115037
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: The highest mortality rates were observed in other non-organic psychoses. Excess mortality rates were also observed in less severe mental conditions. Different natural mortality causes were found for different psychiatric diagnoses. Abstract: We estimated all-cause and cause-specific mortality associated with mental disorder diagnoses using outpatient and inpatient registers from Catalonia. A historical register-based cohort was used, including 516, 944 adults diagnosed with psychotic, mood, or anxiety disorders in 2005-2016, and their matched controls. Six psychiatric groups were created using hierarchical rules. Mortality rate ratios (MRRs), calculated with stratified Cox proportional-hazards models adjusted for mental comorbidity, ranged from 2.45 (95%CI = 2.28-2.64) for other non-organic psychoses to 1.11 (95%CI = 1.08-1.15) for anxiety disorders. Higher MRRs were found in males compared to females with non-organic psychoses, other affective and anxiety disorders, and the excess risk of death was higher in younger ages for all the diagnoses except for schizophrenia. Overall, suicide mortality rates were higher for those with mental disorder diagnoses. The highest MRRs due to natural causes were found for metabolic disorders in schizophrenia, infectious diseases in other non-organic psychoses, and respiratory diseases for bipolar, other affective and anxiety disorders. In the most comprehensive study in Southern Europe, excess mortality is observed not only in people with diagnoses of severe mental disorders, but also in those with other mental disorder diagnoses considered less severe, with an important contribution of both natural and unnatural causes.