Thirty-Day Mortality After Infection Among Persons With Severe Mental Illness: A Population-Based Cohort Study in Denmark

Ribe, Anette Riisgaard; Vestergaard, Mogens; Katon, Wayne; Charles, Morten; Benros, Michael E.; Vanderlip, Erik R.; Nordentoft, Merete; Laursen, Thomas Munk

doi:10.1176/appi.ajp.2015.14091100

Cited by 38 publications

(24 citation statements)

References 35 publications

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“…Thus, the analyses including metastatic stage should be interpreted with caution. In addition, the registration of cause of death in women with SMI in our study could also be subject to differential misclassification caused by expected higher rates of death from external causes, cardiovascular disease, diabetes, or infections in persons with SMI [ 2 , 23 , 35 ]. Further, some important clinical information, such as life style factors (e.g., smoking, physical inactivity, and high BMI) generally associated with SMI [ 8 , 36 ] and poorer prognosis after breast cancer [ 30 , 37 , 38 ], was not included in our analyses due to unavailability in the registers.…”

Section: Discussionmentioning

confidence: 99%

Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort Study

et al. 2016

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BackgroundBreast cancer is the leading cause of cancer death in women worldwide. Nevertheless, it is unknown whether higher mortality after breast cancer contributes to the life-expectancy gap of 15 years in women with severe mental illness (SMI).MethodsWe estimated all-cause mortality rate ratios (MRRs) of women with SMI, women with breast cancer and women with both disorders compared to women with neither disorder using data from nationwide registers in Denmark for 1980–2012.ResultsThe cohort included 2.7 million women, hereof 31,421 women with SMI (12,852 deaths), 104,342 with breast cancer (52,732 deaths), and 1,106 with SMI and breast cancer (656 deaths). Compared to women with neither disorder, the mortality was 118% higher for women with SMI (MRR: 2.18, 95% confidence interval (CI): 2.14–2.22), 144% higher for women with breast cancer (MRR: 2.44, 95% CI: 2.42–2.47) and 327% higher for women with SMI and breast cancer (MRR: 4.27, 95% CI: 3.98–4.57). Among women with both disorders, 15% of deaths could be attributed to interaction. In a sub-cohort of women with breast cancer, the ten-year all-cause-mortality was 59% higher after taking tumor stage into account (MRR: 1.59, 95% CI: 1.47–1.72) for women with versus without SMI.ConclusionsThe mortality among women with SMI and breast cancer was markedly increased. More information is needed to determine which factors might explain this excess mortality, such as differences between women with and without SMI in access to diagnostics, provision of care for breast cancer or physical comorbidity, health-seeking-behavior, and adherence to treatment.

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Section: Discussionmentioning

confidence: 99%

Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort Study

et al. 2016

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“…Individuals with bipolar or psychotic disorder had 52% increased mortality risk within 30 days after their infection. 14 We could not find any study that explicitly explored risk factors associated with death from respiratory infections in individuals with SMD. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in deaths with conditions or causes in addition to COVID-19, there were on average 2.6 additional conditions or causes per death.…”

Section: Anmentioning

confidence: 98%

“…Several other examples of epidemiological studies exist, where mood and psychotic disorders are amalgamated in similar ways. 3,14,41,[45][46][47] Here, we combined psychotic and bipolar disorders into one category because the prevalence for somatic comorbidities and excess mortality are similar for both conditions. 1,2 We did not include severe depression in our SMD variable, since severe depression is a more heterogenous group.…”

Section: Limitationsmentioning

confidence: 99%

Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak – a exploratory cross-sectional analysis of a population-based register study

Maripuu

Bendix

Öhlund

et al. 2020

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Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymised tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four potential risk factors, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were fourfold in the age group between 60 and 79 years. Cardiovascular diseases increased the odds by 50%. Individuals with SMD without any of the risk factors under study had three-folds odds of COVID-19 associated death. Conclusion: Our preliminary results suggest that individuals with SMD are a further group at increased risk of COVID-19 associated death. The factors contributing to this increased mortality risk require clarification.

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“…Prior research linked early childhood pneumonia with adverse long-term health problems like decreased lung function and chronic obstructive pulmonary disease (Svanes et al 2010) (Gray et al 2017) (de Marco et al 2011). Several other studies demonstrated that infections can lead to cognitive impairment (Leibovici 2013)(Benros et al 2015. Accelerated physical aging and an elevated risk of death by suicide associated with infections has also been suggested (Gavazzi & Krause 2002) (Lund-S ørens en et al 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Regarding schizophrenia, an ample body of evidence indicates that infections are generally associated with high frequency of adverse events in this group of patients. First, infections account for leading causes of premature death in schizophrenia (Ribe et al 2015) (John et al 2018) (Brown et al 2010) (Saha et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Risk factors of major infections in schizophrenia. A nationwide Danish register study

Pankiewicz-Dulacz

Chen

Stenager

2019

Journal of Psychosomatic Research

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Thirty-Day Mortality After Infection Among Persons With Severe Mental Illness: A Population-Based Cohort Study in Denmark

Abstract: Persons with severe mental illness have a markedly elevated 30-day mortality after infection. Some of these excess deaths may be prevented by offering individualized and targeted interventions.

Cited by 38 publications

References 35 publications

Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort Study

Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort Study

Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak – a exploratory cross-sectional analysis of a population-based register study

Risk factors of major infections in schizophrenia. A nationwide Danish register study

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