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Mentally Ill Have High Risk Of Cardiovascular Death

A large British study reported in the February issue of Archives of General Psychiatry, one of the JAMA/Archives journals indicates that individuals with severe mental// illnesses are significantly more likely to die from coronary heart disease and stroke, but not cancer, than those without mental illnesses.

Physical health is a concern among those with severe mental illnesses, according to background information in the article. The adverse effects of antipsychotic medication, along with smoking, lifestyle factors and poverty, may contribute to physical illness in this population. However, estimates for rates of cancer and heart disease among the mentally ill have been conflicting.

David P.J. Osborn, Ph.D., and colleagues at the Royal Free and University College Medical School, London, selected 46,136 individuals with severe mental illness (including schizophrenia, schizoaffective disorder, bipolar disorder and delusional disorder) and 300,426 without mental illness from a nationally representative database in the United Kingdom.

The researchers compared the two group's death rates from coronary heart disease, stroke and the seven most common types of cancer in the United Kingdom—respiratory, colorectal, breast, prostate, stomach, esophageal and pancreatic cancer. "We chose to study death rates rather than incidence rates, because mortality is the most robust outcome since it includes diagnoses made post-mortem," the authors write.

Over a follow-up period of at least six months, individuals of all ages were significantly more likely to die from coronary heart disease and stroke if they had a severe mental illness. Those with severe mental illness age 18 to 49 were 3.22 times as likely to die from heart disease and 2.53 times as likely to die from stroke; those age 50 to 75 were 1.86 times more likely to die from heart disease and 1.89 times more likely to die from stroke, and those older than 75 were 1.05 times as likely to d
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