Skip to main content Accessibility help
×
Home
Hostname: page-component-55b6f6c457-rpvk9 Total loading time: 0.183 Render date: 2021-09-26T17:14:19.615Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

The methodological and conceptual aspects of mortality studies in psychiatry

Published online by Cambridge University Press:  11 April 2011

Rights & Permissions[Opens in a new window]

Abstract

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

An extensive literature documented a mortality differential for natural causes between psychiatric patients and the general population. Less clear is the pattern for cancer diseases. Methodological problems arise when trying to explain such mortality gap: selection bias and reverse causation; time-dependent confounders that are also intermediate variables; complex relationships within a life course have to be considered. We try to explain such problems in terms of causal graphs. Excess risk for causes of death which are not attributable to higher prevalence of risk factors or treatment side-effects and higher mortality rates for avoidable causes have been also documented. These findings underline the need for research on health promotion and preventive programs targeted to psychiatric patients.

Type
Editorials
Copyright
Copyright © Cambridge University Press 2010

References

Amaddeo, F., Bisoffi, G., Bonizzato, P., Micciolo, R. & Tansella, M. (1995). Mortality among patients with psychiatric illness. A ten-year case register study in an area with a community-based system of care. British Journal of Psychiatry 166, 783788.CrossRefGoogle Scholar
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists & North American Association for the Study of Obesity (2004). Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes. Journal of Clinical Psychiatry 65, 267272.CrossRefGoogle Scholar
Angrist, J.D., Imbens, G.W. & Rubin, D. (1996). Identification of causal effects using instrumental variables. Journal of the American Statistical Association 91, 444472.CrossRefGoogle Scholar
Barak, Y., Achiron, A., Mandel, M., Mirecki, I. & Aizenberg, D. (2005). Reduced cancer incidence among patients with schizophrenia. Cancer 104, 28172821.CrossRefGoogle ScholarPubMed
Batul, H., Perini, G., Grigoletti, L., Biggeri, A., Tansella, M. & Amaddeo, F. (submitted for publication). Cancer mortality among psychiatric patients treated in a community-based system of care: a 25-year case register study.Google Scholar
Blakely, T. & Fawcett, J. (2005). Bias measuring mortality gradients by occupational class in New Zealand. New Zealand Medical Journal 118, U1253.Google ScholarPubMed
Chwastiak, L.A. (2009). The unchanging mortality gap for people with schizophrenia. Lancet 374, 590592.CrossRefGoogle ScholarPubMed
Cohen, M., Dembling, B. & Schorling, J. (2002). The association between schizophrenia and cancer: a population-based mortality study. Schizophrenia Research 57, 139146.CrossRefGoogle ScholarPubMed
De Hert, M., Dekker, J.M., Wood, D., Kahl, K.G., Holt, R.I. & Möller, H.J. (2009). Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). European Psychiatry 24, 412424.CrossRefGoogle Scholar
Goldblatt, P., Fox, J. & Leon, D. (1990). Mortality of employed men and women. In Longitudinal Study. Mortality and Social Organization (ed. P., Goldblatt), OPCS series LS n. 6. HSMO: London.Google Scholar
Grigoletti, L., Perini, G., Rossi, A., Biggeri, A., Barbui, C., Tansella, M. & Amaddeo, F (2009). Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a communitybased system of care. Psychological Medicine 39, 18751884.CrossRefGoogle Scholar
Grinshpoon, A., Barchana, M., Ponizovsky, A., Lipshitz, I., Nahon, D., Tal, O., Weizman, A. & Levav, I. (2005). Cancer in schizophrenia: is the risk higher or lower? Schizophrenia Research 73, 333341.CrossRefGoogle ScholarPubMed
Harris, E.C. & Barraclough, B. (1998). Excess mortality of mental disorder. British Journal of Psychiatry 173, 1153.CrossRefGoogle ScholarPubMed
Laursen, T.M., Munk-Olsen, T., Agerbo, E., Gasse, C. & Mortensen, P.B. (2009). Somatic hospital contacts, invasive cardiac procedures, and mortality from heart disease in patients with severe mental disorder. Archives of General Psychiatry 66, 713720.CrossRefGoogle ScholarPubMed
Lee, M.S., Johansen, L., Zhang, Y., Wilson, A., Keegan, M., Avery, W., Elliott, P., Borisy, A.A. & Keith, C.T. (2007). The novel combination of chlorpromazine and pentamidine exerts synergistic antiproliferative effects through dual mitotic action. Cancer Research 67, 1135911367.CrossRefGoogle ScholarPubMed
Martikainen, P. & Valkonen, T. (1999). Bias related to the exclusion of the economically inactive in studies on social class differences in mortality. International Journal of Epidemiology 28, 899904.CrossRefGoogle ScholarPubMed
McIntyre, R.S. (2009). Overview of managing medical comorbidities in patients with severe mental illness. Clinical Psychiatry 70, e17.CrossRefGoogle ScholarPubMed
Meloni, D., Miccinesi, G., Bencini, A., Conte, M., Crocetti, E., Zappa, M. & Ferrara, M. (2006). Mortality among discharged psychiatric patients in Florence, Italy. Psychiatric Services 57, 14741481.CrossRefGoogle ScholarPubMed
Newcomer, J.W. (2007). Metabolic syndrome and mental illness. American Journal of Managed Care 13, S170–S177.Google ScholarPubMed
Newcomer, J.W. (2009). Comparing the safety and efficacy of atypical antipsychotics in psychiatric patients with comorbid medical illnesses. Journal of Clinical Psychiatry 70, Suppl. 3, 3036.CrossRefGoogle ScholarPubMed
Pearl, J. (2009). Causality: Models, Reasoning, and Inference 2nd ed. Cambridge University Press: New York.CrossRefGoogle Scholar
Poirier, M.F., Canceil, O., Baylé, F., Millet, B., Bourdel, M.C., Moatti, C., Olié, J.P. & Attar-Lévy, D. (2002). Prevalence of smoking in psychiatric patients. Progress in Neuropsychopharmacol and Biological Psychiatry 26, 529537CrossRefGoogle ScholarPubMed
Prior, P., Hassall, C. & Cross, K.W. (1996). Causes of death associated with psychiatric illness. Journal of Public Health Medicine 18, 381389.CrossRefGoogle ScholarPubMed
Robins, J.M., Hernan, M.A. & Brumback, B. (2000). Marginal structural models and causal inference in epidemiology. Epidemiology 11, 550560.CrossRefGoogle ScholarPubMed
Roshanaei-Moghaddam, B. & Katon, W. (2009). Premature mortality from general medical illnesses among persons with bipolar disorder: a review. Psychiatric Services 60, 147156.CrossRefGoogle ScholarPubMed
Rothman, K.J., Greenland, S. & Lash, T. (2008). Modern Epidemiology, 3rd ed. Lippincott Williams and Wilkins: Philadelphia, US.Google Scholar
Saha, S., Chant, D. & McGrath, J. (2007). A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Archives of General Psychiatry 64, 11231131.CrossRefGoogle ScholarPubMed
Tiihonen, J., Lönnqvist, J., Wahlbeck, K., Klaukka, T., Niskanen, L., Tanskanen, A. & Haukka, J. (2009). 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 374, 620627.CrossRefGoogle ScholarPubMed
Wang, P.S., Schneeweiss, S., Avorn, J., Fischer, M.A., Mogun, H., Solomon, D.H. & Brookhart, M.A. (2005). Risk of death in elderly users of conventional vs. atypical antipsychotic medications. New England Journal of Medicine 353, 23352341.CrossRefGoogle ScholarPubMed
You have Access
2
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The methodological and conceptual aspects of mortality studies in psychiatry
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

The methodological and conceptual aspects of mortality studies in psychiatry
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

The methodological and conceptual aspects of mortality studies in psychiatry
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *