The impact of severe mental illness on lung cancer mortality of patients with lung cancer in Finland in 1990–2013: a register-based cohort study

Arffman, Martti; Manderbacka, Kristiina; Suvisaari, Jaana; Koivunen, Jussi; Lumme, Sonja; Keskimäki, Ilmo; Ahlgrén-Rimpiläinen, Aulikki; Pukkala, Eero

doi:10.1016/j.ejca.2019.06.018

Cited by 12 publications

(9 citation statements)

References 39 publications

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“…Rurality was defined by the current address of accommodation and classified as non-rural (municipalities with more than 5000 inhabitants) and rural (municipalities with less than 5000 inhabitants). These indicators have been found to be reliable ( Arffman et al, 2019 ; Lumme, Manderbacka, & Keskimaki, 2017 ; Vehko, Arffman, Manderbacka, Pukkala, & Keskimaki, 2016 ), and they cover the whole population at risk in our study.…”

Section: Methodssupporting

confidence: 66%

“…In the mortality analyses, we used modified Charlson co-morbidity index ( Arffman et al, 2019 ) to capture a wide variety of potential co-morbidity potentially affecting the association between living alone and mortality. It also describes the general condition of patients which may affect treatment decisions and captures morbidity on a broader scale, including alcohol abuse.…”

Section: Methodsmentioning

confidence: 99%

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Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study

Elovainio

Lumme

Arffman

et al. 2021

SSM - Population Health

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Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000–2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%–80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis.

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Section: Methodssupporting

confidence: 66%

Section: Methodsmentioning

confidence: 99%

Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study

Elovainio

Lumme

Arffman

et al. 2021

SSM - Population Health

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“…Arffman et al [20] performed an observational study using data derived over a 24 year period (1993-2013) from national patient registries in Finland. They identified cases of lung cancer-specific mortality in people with SMI: n=37,852 lung cancer cases were identified of which n=4,640 (12%) had a SMI diagnosis (n=3,629/27,557 (13%) men and n=1,011/10,295 (10%) women).…”

Section: Resultsmentioning

confidence: 99%

“…Psychiatrists and psychiatrically trained nurses may be benefit from palliative care training, and palliative care specialists may benefit from gaining competencies in caring for mentally ill patients [20,26]. This may help reduce the chance of diagnostic overshadowing where physical signs of palliative care needs are misattributed to pre-existing mental health symptoms.…”

Section: Discussionmentioning

confidence: 99%

Supportive and palliative care for people with respiratory problems and preexisting serious mental illness

Peryer

Barnes

Farquhar³

2020

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewPeople living with serious mental illness are at a higher risk of developing respiratory problems that can lead to increased morbidity and early mortality. This review aimed to identify recent advances in care provision for people with respiratory problems and pre-existing serious mental illness to ease symptom burden and reduce the risk of premature mortality. Recent findingsIntervention-based studies in this area are scarce. The evidence reviewed originated from observational studies. Concluding comments from the synthesis suggest there are specific needs for proactive screening of respiratory function as part of routine physical health checks across care settings for people living with serious mental illness, more stringent monitoring of comorbid chronic lung conditions, and increased attention in reducing the frequency respiratory infections. Integrated services across care settings are needed to support people with serious mental illness to limit the impact of modifiable lifestyle factors known to be detrimental to respiratory health, such as smoking. SummaryKey priorities are identified to improve accessibility and inclusivity of respiratory care pathways for people living with serious mental illness to support early detection and proactive monitoring of respiratory problems to help reduce the risk of early mortality.

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“…The most common somatic comorbidities associated with depression are hyperlipidemia, hypertension, diabetes, cardiac arrhythmias, and arthritis, 33 a profile consistent with both these PNES data linkage studies. Multiple comorbidities, inclusive of depression, anxiety, and metabolic syndrome, are all associated with increased mortality in common psychiatric disorders, 34 and comorbid psychosis is known to worsen lung cancer 35 …”

Section: Discussionmentioning

confidence: 99%

Influence of comorbidity on mortality in patients with epilepsy and psychogenic nonepileptic seizures

et al. 2023

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Objective This study aims to determine the contribution of comorbidities to excess psychogenic nonepileptic seizures (PNES) mortality. Methods A retrospective cohort study was conducted of tertiary epilepsy outpatients from St. Vincent's Hospital Melbourne, Australia with an 8:1 comparison cohort, matched by age, sex, and socioeconomic status (SES) to national administrative databases between 2007 and 2017. Privacy‐preserving data linkage was undertaken with the national prescription, National Death Index, and National Coronial Information System. Forty‐five comorbid disease classes were derived by applying the Australian validated RxRisk‐V to all dispensed prescriptions. We fitted Cox proportional hazard models controlling for age, sex, SES, comorbidity, disease duration, and number of concomitant antiseizure medications, as a marker of disease severity. We also performed a parallel forward‐selection change in estimate strategy to explore which specific comorbidities contributed to the largest changes in the hazard ratio. Results A total of 13 488 participants were followed for a median 3.2 years (interquartile range = 2.4–4.0 years), including 1628 tertiary epilepsy outpatients, 1384 patients with epilepsy, 176 with PNES, and 59 with both. Eighty‐two percent of epileptic seizures and 92% of typical PNES events were captured in an epilepsy monitoring unit. The age‐/sex‐/SES‐adjusted hazard ratio was elevated for epilepsy (4.74, 95% confidence interval [CI] = 3.36–6.68) and PNES (3.46, 95% CI = 1.38–8.68) and remained elevated for epilepsy (3.21, 95% CI = 2.22–4.63) but not PNES (2.15, 95% CI = .77–6.04) after comorbidity adjustment. PNES had more pre‐existing comorbidities (p = .0007), with a three times greater median weighted Rx‐RiskV score. Psychotic illness, opioid analgesia, malignancies, and nonopioid analgesia had the greatest influence on PNES comorbid risk. Significance Higher comorbidity appears to explain the excess PNES mortality and may represent either a wider underrecognized somatoform disorder or a psychological response to physical illness. Better understanding and management of the bidirectional relationship of these wider somatic treatments in PNES could potentially reduce the risk of death.

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The impact of severe mental illness on lung cancer mortality of patients with lung cancer in Finland in 1990–2013: a register-based cohort study

Cited by 12 publications

References 39 publications

Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study

Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study

Supportive and palliative care for people with respiratory problems and preexisting serious mental illness

Influence of comorbidity on mortality in patients with epilepsy and psychogenic nonepileptic seizures

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