Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Premature mortality among people with severe mental illness - new evidence from linked primary care data

John, Ann, McGregor, Joanna, Jones, Ian ORCID:, Lee, Sze Chim, Walters, James T.R. ORCID:, Owen, Michael J. ORCID:, O'Donovan, Michael ORCID:, Banos, Marcos Del Pozo, Berridge, Damon and Lloyd, Keith 2018. Premature mortality among people with severe mental illness - new evidence from linked primary care data. Schizophrenia Research 199 , pp. 154-162. 10.1016/j.schres.2018.04.009

[thumbnail of 1-s2.0-S0920996418301981-main.pdf]
PDF - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (586kB) | Preview


Studies assessing premature mortality in people with severe mental illness (SMI) are usually based in one setting, hospital (secondary care inpatients and/or outpatients) or community (primary care). This may lead to ascertainment bias. This study aimed to estimate standardised mortality ratios (SMRs) for all-cause and cause-specific mortality in people with SMI drawn from linked primary and secondary care populations compared to the general population. SMRs were calculated using the indirect method for a United Kingdom population of almost four million between 2004 and 2013. The all-cause SMR was higher in the cohort identified from secondary care hospital admissions (SMR: 2.9; 95% CI: 2.8–3.0) than from primary care (SMR: 2.2; 95% CI: 2.1–2.3) when compared to the general population. The SMR for the combined cohort was 2.6 (95% CI: 2.5–2.6). Cause specific SMRs in the combined cohort were particularly elevated in those with SMI relative to the general population for ill-defined and unknown causes, suicide, substance abuse, Parkinson's disease, accidents, dementia, infections and respiratory disorders (particularly pneumonia), and Alzheimer's disease. Solely hospital admission based studies, which have dominated the literature hitherto, somewhat over-estimate premature mortality in those with SMI. People with SMI are more likely to die by ill-defined and unknown causes, suicide and other less common and often under-reported causes. Comprehensive characterisation of mortality is important to inform policy and practice and to discriminate settings to allow for proportionate interventions to address this health injustice.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Elsevier
ISSN: 0920-9964
Date of First Compliant Deposit: 10 April 2018
Date of Acceptance: 3 April 2018
Last Modified: 10 Jun 2023 17:22

Citation Data

Cited 59 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item


Downloads per month over past year

View more statistics