All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study
ABSTRACT: BACKGROUND: People with mental disorders and intellectual disabilities experience excess mortality compared with the general population. The impact of COVID-19 on exacerbating this, and in widening ethnic inequalities, is unclear. METHODS: Prospective data (N=167,122) from a large mental...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | The Lancet Regional Health. Europe |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776221002143 |
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| author | Jayati Das-Munshi Chin Kuo Chang Ioannis Bakolis Matthew Broadbent Alex Dregan Matthew Hotopf Craig Morgan Robert Stewart |
| author_facet | Jayati Das-Munshi Chin Kuo Chang Ioannis Bakolis Matthew Broadbent Alex Dregan Matthew Hotopf Craig Morgan Robert Stewart |
| author_sort | Jayati Das-Munshi |
| collection | DOAJ |
| description | ABSTRACT: BACKGROUND: People with mental disorders and intellectual disabilities experience excess mortality compared with the general population. The impact of COVID-19 on exacerbating this, and in widening ethnic inequalities, is unclear. METHODS: Prospective data (N=167,122) from a large mental healthcare provider in London, UK, with deaths from 2019 to 2020, used to assess age- and gender-standardised mortality ratios (SMRs) across nine psychiatric conditions (schizophrenia-spectrum disorders, affective disorders, somatoform/ neurotic disorders, personality disorders, learning disabilities, eating disorders, substance use disorders, pervasive developmental disorders, dementia) and by ethnicity. FINDINGS: Prior to the World Health Organization (WHO) declaring COVID-19 a public health emergency on 30th January 2020, all-cause SMRs across all psychiatric cohorts were more than double the general population. By the second quarter of 2020, when the UK experienced substantial peaks in COVID-19 deaths, all-cause SMRs increased further, with COVID-19 SMRs elevated across all conditions (notably: learning disabilities: SMR: 9.24 (95% CI: 5.98-13.64), pervasive developmental disorders: 5.01 (95% CI: 2.40-9.20), eating disorders: 4.81 (95% CI: 1.56-11.22), schizophrenia-spectrum disorders: 3.26 (95% CI: 2.55-4.10), dementia: 3.82 (95% CI: 3.42, 4.25) personality disorders 4.58 (95% CI: 3.09-6.53)). Deaths from other causes remained at least double the population average over the whole year. Increased SMRs were similar across ethnic groups. INTERPRETATION: People with mental disorders and intellectual disabilities were at a greater risk of deaths relative to the general population before, during and after the first peak of COVID-19 deaths, with similar risks by ethnicity. Mortality from non-COVID-19/ other causes was elevated before/ during the pandemic, with higher COVID-19 mortality during the pandemic. FUNDING: ESRC (JD, CM), NIHR (JD, RS, MH), Health Foundation (JD), GSK, Janssen, Takeda (RS). |
| first_indexed | 2024-12-23T04:01:33Z |
| format | Article |
| id | doaj.art-d7b8c6d11f01412f86616b8eb3851a66 |
| institution | Directory Open Access Journal |
| issn | 2666-7762 |
| language | English |
| last_indexed | 2024-12-23T04:01:33Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj.art-d7b8c6d11f01412f86616b8eb3851a662022-12-21T18:00:44ZengElsevierThe Lancet Regional Health. Europe2666-77622021-12-0111100228All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort studyJayati Das-Munshi0Chin Kuo Chang1Ioannis Bakolis2Matthew Broadbent3Alex Dregan4Matthew Hotopf5Craig Morgan6Robert Stewart7King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, London, United Kingdom; South London & Maudsley NHS Foundation Trust, London, United Kingdom; ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom; Corresponding author at: Dr Jayati Das-Munshi, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, London, United Kingdom; South London & Maudsley NHS Foundation Trust, London, United Kingdom; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Global Health Program, College of Public Health, National Taiwan University, Taipei, TaiwanKing's College London, Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; King's College London, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSouth London & Maudsley NHS Foundation Trust, London, United KingdomKing's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, London, United KingdomKing's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, London, United Kingdom; South London & Maudsley NHS Foundation Trust, London, United KingdomESRC Centre for Society and Mental Health, King's College London, London, United Kingdom; King's College London, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomKing's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, London, United Kingdom; South London & Maudsley NHS Foundation Trust, London, United KingdomABSTRACT: BACKGROUND: People with mental disorders and intellectual disabilities experience excess mortality compared with the general population. The impact of COVID-19 on exacerbating this, and in widening ethnic inequalities, is unclear. METHODS: Prospective data (N=167,122) from a large mental healthcare provider in London, UK, with deaths from 2019 to 2020, used to assess age- and gender-standardised mortality ratios (SMRs) across nine psychiatric conditions (schizophrenia-spectrum disorders, affective disorders, somatoform/ neurotic disorders, personality disorders, learning disabilities, eating disorders, substance use disorders, pervasive developmental disorders, dementia) and by ethnicity. FINDINGS: Prior to the World Health Organization (WHO) declaring COVID-19 a public health emergency on 30th January 2020, all-cause SMRs across all psychiatric cohorts were more than double the general population. By the second quarter of 2020, when the UK experienced substantial peaks in COVID-19 deaths, all-cause SMRs increased further, with COVID-19 SMRs elevated across all conditions (notably: learning disabilities: SMR: 9.24 (95% CI: 5.98-13.64), pervasive developmental disorders: 5.01 (95% CI: 2.40-9.20), eating disorders: 4.81 (95% CI: 1.56-11.22), schizophrenia-spectrum disorders: 3.26 (95% CI: 2.55-4.10), dementia: 3.82 (95% CI: 3.42, 4.25) personality disorders 4.58 (95% CI: 3.09-6.53)). Deaths from other causes remained at least double the population average over the whole year. Increased SMRs were similar across ethnic groups. INTERPRETATION: People with mental disorders and intellectual disabilities were at a greater risk of deaths relative to the general population before, during and after the first peak of COVID-19 deaths, with similar risks by ethnicity. Mortality from non-COVID-19/ other causes was elevated before/ during the pandemic, with higher COVID-19 mortality during the pandemic. FUNDING: ESRC (JD, CM), NIHR (JD, RS, MH), Health Foundation (JD), GSK, Janssen, Takeda (RS).http://www.sciencedirect.com/science/article/pii/S2666776221002143 |
| spellingShingle | Jayati Das-Munshi Chin Kuo Chang Ioannis Bakolis Matthew Broadbent Alex Dregan Matthew Hotopf Craig Morgan Robert Stewart All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study The Lancet Regional Health. Europe |
| title | All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study |
| title_full | All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study |
| title_fullStr | All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study |
| title_full_unstemmed | All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study |
| title_short | All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study |
| title_sort | all cause and cause specific mortality in people with mental disorders and intellectual disabilities before and during the covid 19 pandemic cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S2666776221002143 |
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