Mental illness threat to life expectancy similar to heavy smoking
A new analysis by psychiatrists at the University of Oxford in the UK finds that
serious mental disorders can reduce life expectancy by 10 to 20 years – about the same or more
than the impact of heavy smoking. Yet, mental health does not receive the same public health
priority as smoking, they say.
Dr. Seena Fazel, Wellcome Trust senior research fellow at Oxford, and colleagues pooled data
from 20 reviews covering over 1.7 million individuals and over 250,000 deaths. They report their
findings in the open access journal World Psychiatry.
In their analysis, they only included the best systematic reviews of clinical studies that
reported the risk of death for a wide range of mental disorders.
They repeated searches for studies and reviews that examined life expectancy and risk of dying
by suicide, and compared the results with the best data for heavy smoking.
Mental disorders showed increase in mortality risk
They found that all the mental disorders they studied showed an increase in mortality risk –
with wide variation in size of risk – which, in many cases, was on a par with or higher than that tied to heavy
smoking. For example:
- For recurrent depression, the average reduction in life expectancy was 7-11 years
- For bipolar disorder: 9-20
- For schizophrenia: 10-20
- For drug and alcohol abuse: 9-24
- For heavy smoking, the average reduction in life expectancy is 8-10 years.
Mental health disorders, such as bipolar disorder and schizophrenia, reduce life expectancy on par with heavy smoking, researchers found.
Speculating on the reasons behind the figures, Dr. Fazel suggests one problem is the tendency
to treat mental and physical illness as separate conditions, yet:
“Many causes of mental health problems also have physical consequences, and mental illness
worsens the prognosis of a range of physical illnesses, especially heart disease, diabetes and
“The stigma surrounding mental health may mean people aren’t treated as well for physical
health problems when they do see a doctor,” he adds.
He says high-risk behaviors are common in patients with mental illness, especially those with
drug and alcohol disorders. Suicide risk is also higher in psychiatric patients.
‘Prioritize mental health services to prevent early deaths’
He and his colleagues urge governments and health and social services to place a much higher
priority on determining how mental health services can prevent early deaths.
Dr. Fazel refers to the success of public health efforts to reduce smoking. “There are
effective ways to target smoking,” he explains, “and with political will and funding, rates of
smoking-related deaths have started to decline. We now need a similar effort in mental health.”
He says it may be challenging, but it can be done: “There are effective drug and psychological
treatments for mental health problems. We can improve mental health and social care
It is about ensuring people have straightforward access to health care, appropriate jobs and
meaningful daytime activities, he adds, noting that psychiatrists also have a particular
responsibility not to overlook the physical health of their patients.
According to the World
Health Organization, 14% of the global burden of disease is attributed to mental,
neurological, and substance use disorders, which are common in all regions of the world, and
affect every community and age group across all income countries.
The study was funded by the Wellcome Trust.
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