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

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

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.

MeSH terms

  • Accidents
  • Adolescent
  • Adult
  • Bipolar Disorder / mortality*
  • Cause of Death
  • Cohort Studies
  • Depression / mortality*
  • Ethiopia / epidemiology
  • Female
  • Homicide
  • Humans
  • Male
  • Middle Aged
  • Poverty
  • Rural Population / statistics & numerical data
  • Schizophrenia / mortality*
  • Sex Distribution
  • Suicide / statistics & numerical data
  • Young Adult