Avoidable mortality in people with schizophrenia or bipolar disorder in England.

OBJECTIVE: To quantify the extent of 'avoidable mortality' in those with schizophrenia or bipolar disorder and to quantify the effect a reduction in these might have on the mortality gap associated with severe mental illness. METHOD: A cohort was studied of people aged <75 years, d...

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Main Authors: Hoang, U, Goldacre, M, Stewart, R
Format: Journal article
Language:English
Published: 2013
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author Hoang, U
Goldacre, M
Stewart, R
author_facet Hoang, U
Goldacre, M
Stewart, R
author_sort Hoang, U
collection OXFORD
description OBJECTIVE: To quantify the extent of 'avoidable mortality' in those with schizophrenia or bipolar disorder and to quantify the effect a reduction in these might have on the mortality gap associated with severe mental illness. METHOD: A cohort was studied of people aged <75 years, discharged from inpatient care with schizophrenia or bipolar disorder in 2006-2007, and followed up for 365 days. Standardised mortality ratios (SMRs) were calculated followed by hypothetical SMRs, estimating the residual mortality gap if 'avoidable' causes and suicide in the cohorts had occurred at the same level as those in the general population. RESULTS: Avoidable deaths comprised 60.2% and 59.2% of all deaths in the schizophrenia and bipolar disorder cohorts respectively. All-cause SMRs were 4.23 (95% CI 3.85-4.60) and 2.60 (2.21-3.00) respectively. After discounting the excess attributable to avoidable causes and suicide, the SMRs fell to 2.38 (2.09-2.66) and 1.66 (1.35-1.98) respectively. CONCLUSION: Bringing mortality from avoidable causes and suicide down to general population levels would reduce the overall mortality excess in severe mental illness substantially, by about 50%, but would not eliminate it. Other underlying factors beyond those conventionally considered as 'avoidable' need further research.
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spelling oxford-uuid:13333c53-3f1b-4c47-bae8-b954409370472022-03-26T10:12:27ZAvoidable mortality in people with schizophrenia or bipolar disorder in England.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:13333c53-3f1b-4c47-bae8-b95440937047EnglishSymplectic Elements at Oxford2013Hoang, UGoldacre, MStewart, R OBJECTIVE: To quantify the extent of 'avoidable mortality' in those with schizophrenia or bipolar disorder and to quantify the effect a reduction in these might have on the mortality gap associated with severe mental illness. METHOD: A cohort was studied of people aged <75 years, discharged from inpatient care with schizophrenia or bipolar disorder in 2006-2007, and followed up for 365 days. Standardised mortality ratios (SMRs) were calculated followed by hypothetical SMRs, estimating the residual mortality gap if 'avoidable' causes and suicide in the cohorts had occurred at the same level as those in the general population. RESULTS: Avoidable deaths comprised 60.2% and 59.2% of all deaths in the schizophrenia and bipolar disorder cohorts respectively. All-cause SMRs were 4.23 (95% CI 3.85-4.60) and 2.60 (2.21-3.00) respectively. After discounting the excess attributable to avoidable causes and suicide, the SMRs fell to 2.38 (2.09-2.66) and 1.66 (1.35-1.98) respectively. CONCLUSION: Bringing mortality from avoidable causes and suicide down to general population levels would reduce the overall mortality excess in severe mental illness substantially, by about 50%, but would not eliminate it. Other underlying factors beyond those conventionally considered as 'avoidable' need further research.
spellingShingle Hoang, U
Goldacre, M
Stewart, R
Avoidable mortality in people with schizophrenia or bipolar disorder in England.
title Avoidable mortality in people with schizophrenia or bipolar disorder in England.
title_full Avoidable mortality in people with schizophrenia or bipolar disorder in England.
title_fullStr Avoidable mortality in people with schizophrenia or bipolar disorder in England.
title_full_unstemmed Avoidable mortality in people with schizophrenia or bipolar disorder in England.
title_short Avoidable mortality in people with schizophrenia or bipolar disorder in England.
title_sort avoidable mortality in people with schizophrenia or bipolar disorder in england
work_keys_str_mv AT hoangu avoidablemortalityinpeoplewithschizophreniaorbipolardisorderinengland
AT goldacrem avoidablemortalityinpeoplewithschizophreniaorbipolardisorderinengland
AT stewartr avoidablemortalityinpeoplewithschizophreniaorbipolardisorderinengland