Patterns in mortality among people with severe mental disorders across birth cohorts: a register-based study of Denmark and Finland in 1982–2006

Abstract

BackgroundMortality among patients with mental disorders is higher than in general population. By using national longitudinal registers, we studied mortality changes and excess mortality across birth cohorts among people with severe mental disorders in Denmark and Finland.MethodsA cohort of all patients admitted with a psychiatric disorder in 1982–2006 was followed until death or 31 December 2006. Total mortality rates were calculated for five-year birth cohorts from 1918–1922 until 1983–1987 for people with mental disorder and compared to the mortality rates among the general population.ResultsMortality among patients with severe mental disorders declined, but patients with mental disorders had a higher mortality than general population in all birth cohorts in both countries. We observed two exceptions to the declining mortality differences. First, the excess mortality stagnated among Finnish men born in 1963–1987, and remained five to six times higher than at ages 15–24 years in general. Second, the excess mortality stagnated for Danish and Finnish women born in 1933–1957, and remained six-fold in Denmark and Finland at ages 45–49 years and seven-fold in Denmark at ages 40–44 years compared to general population.ConclusionsThe mortality gap between people with severe mental disorders and the general population decreased, but there was no improvement for young Finnish men with mental disorders. The Finnish recession in the early 1990s may have adversely affected mortality of adolescent and young adult men with mental disorders. Among women born 1933–1957, the lack of improvement may reflect adverse effects of the era of extensive hospitalisation of people with mental disorders in both countries.

Public knowledge, attitudes, social distance and reported contact regarding people with mental illness 2009–2015

“…Stigma and discrimination against people with mental health problems have substantial public health impact in England, creating and maintaining inequalities including the following: poor access to mental and physical health care ; reduced life expectancy ; exclusion from higher education and employment ; increased risk of contact with criminal justice systems; victimisation ; poverty and homelessness.…”

Changes in newspaper coverage of mental illness from 2008 to 2014 in England

“…Stigma and discrimination against people with mental illness have substantial public health impact in England, maintaining inequalities including poor access to mental and physical health care , reduced life expectancy , exclusion from higher education , employment , increased risk of contact with criminal justice systems, victimisation , poverty and homelessness. Stigma associated with mental illness is recognised as having a negative impact on the lives of people with mental illness, causing decreased perception of self‐worth and social withdrawal, and leading to social isolation, poor employment, education, housing options and delayed access to services .…”

Trends in standardized mortality among individuals with schizophrenia, 1993–2012: a population-based, repeated cross-sectional study

“…Using hospital admission for case ascertainment misses individuals managed in ambulatory settings and biases the sample toward greater severity, underestimating the prevalence and overestimating the mortality burden of severe mental illness. [11][12][13]15 Mortality in more restricted populations of patients with schizophrenia is likely to be different from that in more hetero geneous populations with severe mental illness, because individuals with schizophrenia have a more chronic course of illness, 16 more cognitive and functional impairment 17 and likely a longer-term exposure to antipsychotics known to be associated with higher risk of diabetes mellitus. 18 Thus, investigating the mortality trends of individuals with schizophrenia is crucial for determining whether they have experienced the same health improvements as the general population or whether other approaches are required to address their unique needs.…”