Life years lost for users of specialized mental healthcare

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2023-09-11 DOI:10.1111/acps.13608

Stefan R. A. Konings, Jochen O. Mierau, Ellen Visser, Richard Bruggeman, Talitha L. Feenstra

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Abstract

Background

Mental disorders are burdensome and are associated with increased mortality. Mortality has been researched for various mental disorders, especially in countries with national registries, including the Nordic countries. Yet, knowledge gaps exist around national differences, while also relatively less studies compare mortality of those seeking help for mental disorders in specialized mental healthcare (SMH) by diagnosis. Additional insight into such mortality distributions for SMH users would be beneficial for both policy and research purposes. We aim to describe and compare the mortality in a population of SMH users with the mortality of the general population. Additionally, we aim to investigate mortality differences between sexes and major diagnosis categories: anxiety, depression, schizophrenia spectrum and other psychotic disorders, and bipolar disorder.

Methods

Mortality and basic demographics were available for a population of N = 10,914 SMH users in the north of The Netherlands from 2010 until 2017. To estimate mortality over the adult lifespan, parametric Gompertz distributions were fitted on observed mortality using interval regression. Life years lost were computed by calculating the difference between integrals of the survival functions for the general population and the study sample, thus correcting for age. Survival for the general population was obtained from Statistics Netherlands (CBS).

Results

SMH users were estimated to lose 9.5 life years (95% CI: 9.4–9.6). Every major diagnosis category was associated with a significant loss of life years, ranging from 7.2 (95% CI: 6.4–7.9) years for anxiety patients to 11.7 (95% CI: 11.0–12.5) years for bipolar disorder patients. Significant differences in mortality were observed between male SMH users and female SMH users, with men losing relatively more life years: 11.0 (95% CI: 10.9–11.2) versus 8.3 (95% CI: 8.2–8.4) respectively. This difference was also observed between sexes within every diagnosis, although the difference was insignificant for bipolar disorder.

Conclusion

There were significant differences in mortality between SMH users and the general population. Substantial differences were observed between sexes and between diagnoses. Additional attention is required, and possibly specific interventions are needed to reduce the amount of life years lost by SMH users.

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接受专门心理保健服务的人损失的生命年数

精神障碍是一种负担，与死亡率增加有关。对各种精神障碍的死亡率进行了研究，特别是在设有国家登记的国家，包括北欧国家。然而，国家差异之间存在着知识差距，而相对较少的研究通过诊断来比较那些在专业精神卫生保健(SMH)中寻求精神障碍帮助的人的死亡率。进一步了解SMH使用者的这种死亡率分布将有利于政策和研究目的。我们的目的是描述和比较SMH用户人群的死亡率与一般人群的死亡率。此外，我们的目标是调查性别和主要诊断类别之间的死亡率差异:焦虑、抑郁、精神分裂症谱系和其他精神障碍，以及双相情感障碍。方法对2010年至2017年荷兰北部N = 10,914名SMH使用者的死亡率和基本人口统计数据进行分析。为了估计成人寿命期间的死亡率，使用区间回归对观察到的死亡率进行参数Gompertz分布拟合。通过计算一般人群和研究样本的生存函数积分之间的差值来计算生命损失年数，从而校正年龄。一般人群的生存率来自荷兰统计局(CBS)。结果SMH使用者估计损失9.5个生命年(95% CI: 9.4-9.6)。每一个主要诊断类别都与显著的生命年损失相关，从焦虑患者的7.2年(95% CI: 6.4-7.9)到双相情感障碍患者的11.7年(95% CI: 11.0-12.5)不等。男性SMH使用者和女性SMH使用者之间的死亡率存在显著差异，男性损失的寿命年相对较多:分别为11.0 (95% CI: 10.9-11.2)和8.3 (95% CI: 8.2-8.4)。尽管双相情感障碍的差异不显著，但在每一种诊断中，性别之间也存在这种差异。结论SMH使用者的死亡率与普通人群有显著差异。在性别和诊断之间观察到实质性的差异。需要给予更多的关注，并可能需要采取具体的干预措施，以减少SMH使用者损失的生命年数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.