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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Phillipa on July 9, 2010, at 23:58:24
Seems premature death from 13-32 years can result from mental illness. Both from Anxiety,Depression, Bipolar, Schizophenia, From the Meds that Treat also. Phillipa scarey study
From Medscape Medical News
Premature Mortality Linked With Serious Mental Illness
Deborah Brauser
July 9, 2010 Patients with serious and persistent mental illness have significantly more years of potential life lost (YPLL) than do those without the disorders, according to a new retrospective study.
Although suicide, cancer, accidents, liver disease, and septicemia all contributed to increased premature mortality in the study's mentally ill participants compared with a general population sample, the leading cause of death for both groups was heart disease, according to the researchers.
"We found that a community-based sample of adults with severe and persistent mental illness lost 14.5 years of potential life, a difference of 4.2 years from the [control] sample," write lead study author Elizabeth E. Piatt, PhD, from the Department of Behavioral and Community Health Sciences at Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, and colleagues.
"Our work adds to the growing body of literature that highlights the need for better preventive health care for persons with mental illness. Along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on these preventable causes of early death," the investigators add.
The study is published in the July issue of Psychiatric Services.
YPLL Comparisons Important
[Past] studies that have examined life expectancy "have shown that persons with mental illness die much sooner than those without mental illness." The investigators also note that this includes a report by the National Association of State Mental Health Program Directors, which showed that "persons with serious mental illness die on average between 13.5 and 32.2 years earlier than the general population."
However, few studies have looked at comparisons of YPLL between those with and without mental illness, note the study authors. "By not examining differences in premature mortality, the results of these studies may have overestimated [this outcome] in the population with serious mental illness."
In addition, many of the previous work in this area "has been based on samples of consumers who have been hospitalized or on mixed inpatient and outpatient samples," they write. "The sample in [our] study is more representative than state hospital samples."
The investigators retrospectively matched case management files from a community mental health care center in Ohio to state death records from 1998 to 2004. Data from 647 decedents with serious and persistent mental disorders (65.8% white, 33.7% black) were then compared with data from 15,517 decedents in the general population. The mean ± SD age for the entire study population was 79.4 ± 11.1 years and 56% were female.
Serious mental illnesses included schizophrenia and schizoaffective disorder; dysthymic, major depressive, and bipolar disorders; and anxiety and personality disorders. For this study, serious mental illness did not include a primary diagnosis of either substance use disorder or dementia.
Significant Differences Found for All Causes of Death
Results showed that the unadjusted mean ± SD YPLL was 14.5 ± 10.6 for the decedents with serious and persistent mental illness vs 10.3 ± 6.7 for the general population. The mean ± SD age at death was 73.4 ± 15.4 vs 79.6 ± 10.9 years, respectively.
After adjusting for sex, race, marital status, and education, significant differences in YPLL between the 2 study groups were found for all causes of death, with the greatest difference found for accidents (13.1 years; P = .001), suicide (9.7 years; P = .038), cancers (5 years; P = .001), septicemia (5 years; P = .006), and liver disease (4.8 years; P = .001).
However, "differences in cause of death did not explain the difference in YPLL," the investigators write.
They also note that the difference of 4.2 years in unadjusted YPLL found between the 2 groups was a smaller gap than reported in previous studies. "The results...suggest that although consumers in a community setting experience a significant degree of premature mortality, they may experience it to a lesser degree than [those] who were recently hospitalized before their death."
Overall, "morbidity and mortality from the most common causes of death in this sample...may be reduced by effective medical care that attempts prevention, early detection, and chronic disease management."
"Integrating mental health care, primary health care, and wellness-promoting activities...may ensure access to the interventions needed to reverse the causes of preventable early death," they add.
An Important Building Block
"This is really important data that will help substantiate the idea that people with serious mental illness are very health underserved," Anita S. Everett, MD, section chief of community and general psychiatry at Johns Hopkins Bayview Medical Center in Baltimore, Maryland, told Medscape Medical News.
"What I really like is that the study focuses on patients who are actively being served by community mental health centers rather than large state-level databases, giving us more 'here and now' information," added Dr. Everett, who was not involved with this study.
"For clinicians, it provides a solid contribution to our knowledge and awareness of early death of people who have mental illness," she noted. "It also provides support for community mental health centers to be able to start addressing some of the health needs of these individuals so that we can work on prevention and early intervention health strategies to try to avert these causes of premature mortality."
In addition, "having strong literature helps us to be able to engage the primary care providers in paying attention to the needs of this population," said Dr. Everett.
Need for Physical and Mental Care
Wayne Katon, MD, professor and vice chair in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in Seattle, recently did a systematic review of 17 studies that looked at premature mortality associated with bipolar disorder. "The data from that showed pretty clearly that people with this illness were dying as much as 10 to 20 years earlier."
"There's no doubt that among people with serious mental illness, [those] who get hospitalized more are more likely to die earlier because hospitalization suggests a higher degree of severity. In this study that looked more at community people with serious mental illness, they're still finding the increased mortality. That's an interesting and important finding," said Dr. Katon, who was not involved in this study.
He told Medscape Medical News that there may be several reasons for this increase. "People with mental health illness often have habits such as smoking and obesity and a sedentary lifestyle that leads to premature mortality. But there's also intriguing research that suggests there may be biological pathways to this such that the chronic stress folks with mental illness experience may lead to increased hypothalamic pituitary activity, increased cortisone levels, increased proinflammatory factors leading to such things as stroke and heart attacks, and abnormalities of the autonomic nervous system that might lead to more heart disease and sudden death issues."
Dr. Katon also noted that some of the medications for treating mental illness can provoke obesity by increasing appetite and can induce the development of type 2 diabetes and heart disease.
"Overall, I think psychiatrists need to go back to their medical training. We need to be screening for hypertension and high blood sugars, need to be watching patients carefully when we put them on medications that they're not developing obesity, and need to be counseling our patients about the importance of quitting smoking, about healthy diet, and about exercise," he said.
"We need to take care of the whole patient as psychiatrists and not just be concerned with their mental state because they're often not getting good monitoring of their physical state by other doctors," concluded Dr. Katon.
The study authors, Dr. Everett, and Dr. Katon have disclosed no relevant financial relationships.
Psychiatr Serv. 2010;61:663-668.
Posted by SLS on July 10, 2010, at 4:35:47
In reply to Premature Death Linked To Mental Illness, posted by Phillipa on July 9, 2010, at 23:58:24
Chronic stress is a killer.
- Scott
Posted by linkadge on July 10, 2010, at 9:18:57
In reply to Re: Premature Death Linked To Mental Illness, posted by SLS on July 10, 2010, at 4:35:47
I think that in some cases, the medications can be a big factor. If you gain 75 pounds and get diabetes on zyprexa, this will significantly increase your risk of heart disease.
Linkadge
Posted by jade k on July 10, 2010, at 22:08:17
In reply to Re: Premature Death Linked To Mental Illness, posted by SLS on July 10, 2010, at 4:35:47
> Chronic stress is a killer.
>
>
> - Scott
Its sad is what it is.~Jade
Posted by herpills on July 11, 2010, at 20:19:07
In reply to Premature Death Linked To Mental Illness, posted by Phillipa on July 9, 2010, at 23:58:24
"Overall, I think psychiatrists need to go back to their medical training. We need to be screening for hypertension and high blood sugars, need to be watching patients carefully when we put them on medications that they're not developing obesity, and need to be counseling our patients about the importance of quitting smoking, about healthy diet, and about exercise,"
That's the key phrase right there. I've had several pdocs, inpatient and outpatient, none of them ever talk to you about what it means to have a healthy lifestyle. I'm still working it out on my own. The docs just give out the pills.
herpills
Posted by Phillipa on July 11, 2010, at 20:33:16
In reply to Re: Premature Death Linked To Mental Illness » Phillipa, posted by herpills on July 11, 2010, at 20:19:07
Seriously in other words back to the day when one doc treated the whole patient. Not all these specialists? Phillipa
Posted by emmanuel98 on July 11, 2010, at 20:36:11
In reply to Re: Premature Death Linked To Mental Illness » Phillipa, posted by herpills on July 11, 2010, at 20:19:07
My p-doc regularly asks about diet, exercise, how I'm sleeping, how much I drink (not because I drink so much, but because I need to lose weight). I gained a ton of weight on abilify, which he prescribed. He never warned me about weight gain, but that's because abilify is one of the least likely AP's to cause weight gain.So I wouldn't say all p-docs are irresponsible. Mine certainly is not.
Posted by bleauberry on July 13, 2010, at 19:40:11
In reply to Premature Death Linked To Mental Illness, posted by Phillipa on July 9, 2010, at 23:58:24
I don't think it is the mental illness that causes early death. It is more likely the actual illness that is causing the mental illness that shortens life. In addition to that, people chronically feel bad are probably not doing what they need to do to combat disease and optimize health. As important as it is for a normal healthy person to eat wise and exercise and such, it becomes ten times more important when chronic illness is involved. Another factor is the will to live. I think when someone has been chronically ill for a long time their will to live is probably not as strong as someone else enjoying a bountiful life. So in my opinion it is a constellation of factors involved that contribute to premature death, not the mental illness per se.
More dangerous than mental illness though, just to put it in perspective, are:
Automobiles
Alcohol
Cigarettes
OverweightPremature deaths by them I am sure dwarf premature deaths of mental disease.
Posted by jade k on July 14, 2010, at 15:16:41
In reply to Re: Premature Death Linked To Mental Illness, posted by bleauberry on July 13, 2010, at 19:40:11
> I don't think it is the mental illness that causes early death.
I agree.
>It is more likely the actual illness that is causing the mental illness that shortens life.
Bleau, I'm not sure what you mean by the actual illness. Are you referring to infections, etc. that can't be detected?
>In addition to that, people chronically feel bad are probably not doing what they need to do to combat disease and optimize health. As important as it is for a normal healthy person to eat wise and exercise and such, it becomes ten times more important when chronic illness is involved.
And ten times as difficult :-(
I actually see this as the likely culprit.>Another factor is the will to live. I think when someone has been chronically ill for a long time their will to live is probably not as strong as someone else enjoying a bountiful life. So in my opinion it is a constellation of factors involved that contribute to premature death, not the mental illness per se.
This sounds right to me.
~Jade
Posted by Zyprexa on July 17, 2010, at 0:56:21
In reply to Re: Premature Death Linked To Mental Illness » Phillipa, posted by herpills on July 11, 2010, at 20:19:07
My Pdoc checks my weight when I go in to see her.
I wonder if its your teeth that gives you diabettes not the zyprexa. I developed diabettes when I started geodon. I went back on zyprexa and still diabettic. Then I was diagnosed with periodontal disease. They started treating it and within a couple years the diabetes slowely went away. I've read that periodontal disease can cause diabetes and a lot of other health problems.
Posted by jade k on July 17, 2010, at 1:13:00
In reply to Zyprexa Diabetes and Teeth., posted by Zyprexa on July 17, 2010, at 0:56:21
Hi,
You are correct. There is a connection between periodontal disease and diabetes.
Strange but true. See Perio.org or google.
~Jade
This is the end of the thread.
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