Friday, July 17, 2009

Mortality, heart disease and mental illness

People with severe mental-health problems have a particularly high death rate from heart disease. The reasons put forward to explain this include the side effects of drugs, unhealthy diets, high cholesterol, high blood pressure, diabetes, high rates of smoking and the stigma of having a mental-health problem. Researchers from Aarhus University in Denmark studied 4.6 million people between 1994 and 2007 looking into people's contacts with the health service with cardiovascular problems, their death's from heart disease and any operations they might have had for heart problems. They found that people with severe mental illness (defined in the study as people with schizophrenia, bipolar affective disorder, and schizoaffective disorder) only had a slightly-higher rate of heart disease - 11% higher - than other people. However, they were nearly three times more likely to die of heart disease. Five years after people's first contact with the medical profession with heart disease 8.26% of people with a serious mental illness had died compared to only 2.86% of people without a mental illness. Only 7.04% of people with a severe mental illness had a heart operation 5 years after being diagnosed compared to 12.27% of the rest of the population. The researchers concluded that the treatment offered to people with a severe mental illness for their heart disease was neither sufficiently efficient nor sufficiently intensive and that "this undertreatment may explain part of their excess mortality."

Laursen, Thomas Munk ... [et al] - Somatic hospital contacts, invasive cardiac procedures, and mortality from heart disease in patients with severe mental disorder Archives of General Psychiatry July 2009, 66(7), 713-720

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