The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers.
The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers.
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DOI：
10.1136/bmj.f2539
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发表时间：
2013-05-21
期刊：
影响因子：
--
通讯作者：
Kisely S
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文献类型：
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作者：
Lawrence D;Hancock KJ;Kisely S
目的比较西澳大利亚州精神病患者与普通人群的死亡率。设计基于人群的研究。西澳大利亚州，1985-2005年。参加者精神病患者（292 585）在西澳大利亚州的精神卫生服务登记。主要观察指标：与西澳大利亚州人口相比，精神病患者的预期寿命趋势和死亡率过高的原因，包括身体健康状况和非自然死亡原因。结果当使用主动患病率的障碍（接触服务，在过去的五年），预期寿命差距从13.5年增加到15.9年的男性和10.4至12.0年的女性在1985年和2005年之间。此外，77.7%的超额死亡归因于身体健康状况，包括心血管疾病（29.9%）和癌症（13.5%）。自杀是13.9%的额外死亡的原因。结论：尽管人们知道精神疾病患者的死亡率过高，但自1985年以来，他们与普通人群的预期寿命差距差距已经扩大。由于大多数超额死亡是由于身体健康状况，除了不断努力防止自杀外，公共努力还应致力于改善身体健康，以降低精神疾病患者的死亡率。
Objective To examine the mortality experience of psychiatric patients in Western Australia compared with the general population. Design Population based study. Setting Western Australia, 1985-2005. Participants Psychiatric patients (292 585) registered with mental health services in Western Australia. Main outcome measures Trends in life expectancy for psychiatric patients compared with the Western Australian population and causes of excess mortality, including physical health conditions and unnatural causes of death. Results When using active prevalence of disorder (contact with services in previous five years), the life expectancy gap increased from 13.5 to 15.9 years for males and from 10.4 to 12.0 years for females between 1985 and 2005. Additionally, 77.7% of excess deaths were attributed to physical health conditions, including cardiovascular disease (29.9%) and cancer (13.5%). Suicide was the cause of 13.9% of excess deaths. Conclusions Despite knowledge about excess mortality in people with mental illness, the gap in their life expectancy compared with the general population has widened since 1985. With most excess deaths being due to physical health conditions, public efforts should be directed towards improving physical health to reduce mortality in people with mental illness, in addition to ongoing efforts to prevent suicide.