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Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland

BACKGROUND: People with severe mental illness (SMI) die prematurely, mostly due to preventable causes. OBJECTIVE: To examine multimorbidity and mortality in people living with SMI using linked administrative datasets. METHOD: Analysis of linked electronically captured routine hospital administrative...

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Autores principales: McCarter, Rachel, Rosato, Michael, Thampi, Annette, Barr, Ruth, Leavey, Gerard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594365/
https://www.ncbi.nlm.nih.gov/pubmed/37578131
http://dx.doi.org/10.1192/j.eurpsy.2023.2441
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author McCarter, Rachel
Rosato, Michael
Thampi, Annette
Barr, Ruth
Leavey, Gerard
author_facet McCarter, Rachel
Rosato, Michael
Thampi, Annette
Barr, Ruth
Leavey, Gerard
author_sort McCarter, Rachel
collection PubMed
description BACKGROUND: People with severe mental illness (SMI) die prematurely, mostly due to preventable causes. OBJECTIVE: To examine multimorbidity and mortality in people living with SMI using linked administrative datasets. METHOD: Analysis of linked electronically captured routine hospital administrative data from Northern Ireland (2010–2021). We derived sex-specific age-standardised rates for seven chronic life-limiting physical conditions (chronic kidney disease, malignant neoplasms, diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, myocardial infarction, and stroke) and used logistic regression to examine the relationship between SMI, socio-demographic indicators, and comorbid conditions; survival models quantified the relationship between all-cause mortality and SMI. RESULTS: Analysis was based on 929,412 hospital patients aged 20 years and above, of whom 10,965 (1.3%) recorded a diagnosis of SMI. Higher likelihoods of an SMI diagnosis were associated with living in socially deprived circumstances, urbanicity. SMI patients were more likely to have more comorbid physical conditions than non-SMI patients, and younger at referral to hospital for each condition, than non-SMI patients. Finally, in fully adjusted models, SMI patients had a twofold excess all-cause mortality. CONCLUSION: Multiple morbidities associated with SMI can drive excess mortality. While SMI patients are younger at referral to treatment for these life-limiting conditions, their relatively premature death suggests that these conditions are also quite advanced. There is a need for a more aggressive approach to improving the physical health of this population.
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spelling pubmed-105943652023-10-25 Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland McCarter, Rachel Rosato, Michael Thampi, Annette Barr, Ruth Leavey, Gerard Eur Psychiatry Research Article BACKGROUND: People with severe mental illness (SMI) die prematurely, mostly due to preventable causes. OBJECTIVE: To examine multimorbidity and mortality in people living with SMI using linked administrative datasets. METHOD: Analysis of linked electronically captured routine hospital administrative data from Northern Ireland (2010–2021). We derived sex-specific age-standardised rates for seven chronic life-limiting physical conditions (chronic kidney disease, malignant neoplasms, diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, myocardial infarction, and stroke) and used logistic regression to examine the relationship between SMI, socio-demographic indicators, and comorbid conditions; survival models quantified the relationship between all-cause mortality and SMI. RESULTS: Analysis was based on 929,412 hospital patients aged 20 years and above, of whom 10,965 (1.3%) recorded a diagnosis of SMI. Higher likelihoods of an SMI diagnosis were associated with living in socially deprived circumstances, urbanicity. SMI patients were more likely to have more comorbid physical conditions than non-SMI patients, and younger at referral to hospital for each condition, than non-SMI patients. Finally, in fully adjusted models, SMI patients had a twofold excess all-cause mortality. CONCLUSION: Multiple morbidities associated with SMI can drive excess mortality. While SMI patients are younger at referral to treatment for these life-limiting conditions, their relatively premature death suggests that these conditions are also quite advanced. There is a need for a more aggressive approach to improving the physical health of this population. Cambridge University Press 2023-08-14 /pmc/articles/PMC10594365/ /pubmed/37578131 http://dx.doi.org/10.1192/j.eurpsy.2023.2441 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Research Article
McCarter, Rachel
Rosato, Michael
Thampi, Annette
Barr, Ruth
Leavey, Gerard
Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland
title Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland
title_full Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland
title_fullStr Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland
title_full_unstemmed Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland
title_short Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland
title_sort physical health disparities and severe mental illness: a longitudinal comparative cohort study using hospital data in northern ireland
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594365/
https://www.ncbi.nlm.nih.gov/pubmed/37578131
http://dx.doi.org/10.1192/j.eurpsy.2023.2441
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