Chiu Ying-Ming, Huang Wei-Lieh, Wang Shih-Heng, Wu Ming-Shiang, Chen Yu-Ling, Hsu Chih-Cheng, Wu Chi-Shin
Department of Allergy, Immunology, and Rheumatology, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Nursing, Jen Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan.
Gen Hosp Psychiatry. 2024 Nov-Dec;91:25-32. doi: 10.1016/j.genhosppsych.2024.08.006. Epub 2024 Aug 17.
This study employed a national longitudinal cohort to assess expected years of life lost (EYLL) in newly diagnosed psychiatric patients.
Data from Taiwan's National Death Registry and Health Insurance Research Database were scrutinized to identify patients with various psychiatric disorders. Disorders were ranked hierarchically, and age groups were categorized as young, middle-aged, and older adults. We utilized the semiparametric survival extrapolation method to estimate life expectancy (LE) and EYLL. Modifying effect of comorbid conditions and socioeconomic characteristics were also explored.
Among the 5,757,431 cases, young adults with dementia, alcohol use disorder, schizophrenia, and bipolar disorder experienced an excess of 15 years of EYLL. Middle-aged adults faced approximately 9 years or more of EYLL, while older adults had lower EYLL values. Comorbid conditions, low income levels, and living in rural areas were associated with higher EYLL.
This study underscores the substantial EYLL among young adults with psychiatric disorders and the significant impact of specific disorders on EYLL. Early intervention, tailored support, and healthcare system readiness are imperative for improved outcomes. Resource allocation and targeted interventions focusing on early detection and comprehensive treatment can alleviate the economic burden.
本研究采用全国纵向队列研究来评估新诊断精神疾病患者的预期寿命损失年数(EYLL)。
对来自台湾地区国家死亡登记处和健康保险研究数据库的数据进行仔细审查,以确定患有各种精神疾病的患者。对疾病进行分层排序,并将年龄组分为年轻人、中年人和老年人。我们利用半参数生存外推法来估计预期寿命(LE)和EYLL。还探讨了合并症和社会经济特征的修正作用。
在5757431例病例中,患有痴呆症、酒精使用障碍、精神分裂症和双相情感障碍的年轻成年人的EYLL超过15年。中年成年人面临约9年或更长时间的EYLL,而老年人的EYLL值较低。合并症、低收入水平和居住在农村地区与较高的EYLL相关。
本研究强调了患有精神疾病的年轻成年人中存在大量的EYLL,以及特定疾病对EYLL的重大影响。早期干预、量身定制的支持以及医疗系统的准备情况对于改善结果至关重要。资源分配和针对早期检测与综合治疗的有针对性干预措施可以减轻经济负担。