Serious mental illness reduces life expectancy by 10 to 20 years, a new analysis by Oxford University psychiatrists has shown , which is a loss of years that is equivalent to or worse than that for heavy smoking. However, mental health has not seen the same public health priority, say the Oxford scientists, despite these stark figures and the similar prevalence of mental health problems.
Around 1 in 4 people in the UK will experience some kind of mental health problem in the course of a year and around 21% of British men and 19% of women smoke cigarettes.
The researchers say the figures should galvanise governments and health and social services to put a much higher priority on how mental health services can prevent early deaths.
The researchers searched for the best systematic reviews of clinical studies that reported mortality risk for a whole range of diagnoses including mental health problems, substance and alcohol abuse, dementia, autistic spectrum disorders, learning disability and childhood behavioural disorders. They identified 20 review papers that included over 1.7 million individuals and over 250,000 deaths.
They repeated searches for studies and reviews reporting life expectancy and risk of dying by suicide, and compared the results to the best data for heavy smoking.
The average reduction in life expectancy in people with bipolar disorders was found to be between 9 and 20 years, for schizophrenia it is 10 to 20 years, for drug and alcohol abuse it is between 9 and 24 years, and for recurrent depression around 7 to 11 years. By comparison, the loss of years among heavy smokers is 8-10 years.
All diagnoses studied showed an increase in mortality risk, though the size of the risk varied greatly. Many had risks equivalent to or higher than heavy smoking. Dr Seena Fazel of the Department of Psychiatry at Oxford University said: “We found that many mental health diagnoses are associated with a drop in life expectancy as great as that associated with smoking 20 or more cigarettes a day. There are likely to be many reasons for this. High-risk behaviours are common in psychiatric patients, especially drug and alcohol abuse, and they are more likely to die by suicide. The stigma surrounding mental health may mean people aren't treated as well for physical health problems when they do see a doctor.”
The Oxford University researchers report their findings in the journal World Psychiatry. The study was funded by the Wellcome Trust.
