严重精神疾病患者的超额死亡率：埃塞俄比亚农村地区的 10 年基于人群的队列研究。

Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia.

机构信息

Abebaw Fekadu, MD, MSc, MRCPsych, PhD, Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia and King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, UK; Girmay Medhin, MSc, PhD, Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; Derege Kebede, MD, DSc, WHO Regional Office for Africa, Brazzaville, Republic of Congo; Atalay Alem, MD, PhD, Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Anthony J. Cleare, BSc, MBBS, MRCPsych, PhD, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, UK; Martin Prince, MD, MSc, FRCPsych, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research Department; Charlotte Hanlon, BMBS, MSc, MRCPsych, PhD, Teshome Shibre, MD, PhD, Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Br J Psychiatry. 2015 Apr;206(4):289-96. doi: 10.1192/bjp.bp.114.149112. Epub 2015 Feb 5.

DOI:10.1192/bjp.bp.114.149112

PMID:25657358

Abstract

BACKGROUND

Evidence on mortality in severe mental illness (SMI) comes primarily from clinical samples in high-income countries.

AIMS

To describe mortality in people with SMI among a population cohort from a low-income country.

METHOD

We followed-up 919 adults (from 68 378 screened) with SMI over 10 years. Standardised mortality ratios (SMR) and years of life lost (YLL) as a result of premature mortality were calculated.

RESULTS

In total 121 patients (13.2%) died. The overall SMR was twice that of the general population; higher for men and people with schizophrenia. Patients died about three decades prematurely, mainly from infectious causes (49.6%). Suicide, accidents and homicide were also common causes of death.

CONCLUSIONS

Mortality is an important adverse outcome of SMI irrespective of setting. Addressing common natural and unnatural causes of mortality are urgent priorities. Premature death and mortality related to self-harm should be considered in the estimation of the global burden of disease for SMI.

摘要