Reducing excess mortality due to chronic disease in people with severe mental illness: meta-review of health interventions

Amanda J Baxter; Meredith G Harris; Yasmin Khatib; Traolach S Brugha; Heidrun Bien; Kamaldeep Bhui

doi:10.1192/bjp.bp.115.163170

Reducing excess mortality due to chronic disease in people with severe mental illness: meta-review of health interventions

Br J Psychiatry. 2016 Apr;208(4):322-9. doi: 10.1192/bjp.bp.115.163170. Epub 2016 Mar 3.

Authors

Amanda J Baxter¹, Meredith G Harris², Yasmin Khatib², Traolach S Brugha², Heidrun Bien², Kamaldeep Bhui²

Affiliations

¹ Amanda J. Baxter, PhD, Meredith G. Harris, MPH, MPASR, University of Queensland, School of Public Health, Herston, and Policy and Epidemiology Group, Queensland Centre for Mental Health, Wacol, Australia; Yasmin Khatib, PhD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, UK; Traolach S. Brugha, MD, PhD, Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester, UK; Heidrun Bien, PhD, Kamaldeep Bhui, MD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, UK amanda_baxter@qcmhr.uq.edu.au.
² Amanda J. Baxter, PhD, Meredith G. Harris, MPH, MPASR, University of Queensland, School of Public Health, Herston, and Policy and Epidemiology Group, Queensland Centre for Mental Health, Wacol, Australia; Yasmin Khatib, PhD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, UK; Traolach S. Brugha, MD, PhD, Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester, UK; Heidrun Bien, PhD, Kamaldeep Bhui, MD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, UK.

PMID: 26941263
DOI: 10.1192/bjp.bp.115.163170

Abstract

Background: People with severe mental illness (SMI) have high rates of chronic disease and premature death.

Aims: To explore the strength of evidence for interventions to reduce risk of mortality in people with SMI.

Method: In a meta-review of 16 systematic reviews of controlled studies, mortality was the primary outcome (8 reviews). Physiological health measures (body mass index, weight, glucose levels, lipid profiles and blood pressure) were secondary outcomes (14 reviews).

Results: Antipsychotic and antidepressant medications had some protective effect on mortality, subject to treatment adherence. Integrative community care programmes may reduce physical morbidity and excess deaths, but the effective ingredients are unknown. Interventions to improve unhealthy lifestyles and risky behaviours can improve risk factor profiles, but longer follow-up is needed. Preventive interventions and improved medical care for comorbid chronic disease may reduce excess mortality, but data are lacking.

Conclusions: Improved adherence to pharmacological and physical health management guidelines is indicated.

Publication types

Review

MeSH terms

Chronic Disease / drug therapy
Chronic Disease / mortality*
Chronic Disease / therapy*
Humans
Mental Disorders / complications*
Mental Disorders / mortality*
Outcome and Process Assessment, Health Care*