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Premature deaths among individuals with severe mental illness after discharge from long-term hospitalisation in Japan: A naturalistic observation during a 24-year period

  • Shinsuke Kondo (a1), Yousuke Kumakura (a2), Akiko Kanehara (a3), Daisuke Nagato (a4), Taro Ueda (a4), Tsuneo Matsuoka (a4), Yukiko Tao (a4) and Kiyoto Kasai (a1)...
Abstract
Background

Premature death in individuals with severe mental illness (SMI) in countries without nationally collected data, including Japan, is structurally underreported.

Aims

To elucidate excess mortality among individuals with SMI in Japan.

Method

We retrospectively investigated all deaths among users of a non-clinical community-based mental health service provider in suburban Tokyo from 1992 to 2015.

Results

During the study period, 45 individuals died among 254 qualified registrants. Deaths were by natural causes in 33 cases (73.3%). The mean years of life lost was 22.2 years and the overall standard mortality ratio (SMR) was 3.28 (95% CI 2.40–4.39). The cause-specific SMR was 5.09 (95% CI 2.33–9.66) for cardiovascular disease and 7.38 (95% CI 2.40–17.22) for suicide.

Conclusions

Although Japan leads the world in longevity, individuals with SMI suffer premature death and excess mortality due to physical conditions as well as suicide. Revealing this underreported disparity of life is the first step to improving physical care for individuals with SMI.

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Copyright
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
Corresponding author
Correspondence: Shinsuke Kondo, Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo, Japan. E-mail: kondo-psy@umin.ac.jp
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Declaration of interest

S.K. received personal fees from Pfizer and Dainippon-Sumitomo, outside the submitted work, and was a medical adviser to Sudachi-kai. Y.K. received grants from Japan Foundation for Neuroscience and Mental Health (JFNMH), during the conduct of the study, and personal fees from Dainippon-Sumitomo, outside the submitted work. K.K. received grants from Japan Society for the Promotion of Science (JSPS) and Japan Agency for Medical Research and Development (AMED), during the conduct of the study; personal fees from Daiichi-Sankyo, Otsuka, Meiji-Seika Pharma, Yoshitomi, Mochida and Fuji-Film RI Pharma; grants and personal fees from MSD, Astellas, Dainippon-Sumitomo and Eisai; and grants from Lily, Takeda and Tanabe-Mitsubishi, outside the submitted work.

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References
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1 Laursen, TM, Nordentoft, M, Mortensen, PB. Excess early mortality in schizophrenia. Annu Rev Clin Psychol 2014; 10: 425–48.
2 Ng, C, Setoya, Y, Koyama, A, Takeshima, T. The ongoing development of community mental health services in Japan: utilizing strengths and opportunities. Australas Psychiatry 2010; 18: 5762.
3 Ministry of Health Labour and Welfare. National Life Table. 1992–2015. (http://www.mhlw.go.jp/toukei/saikin/hw/seimei/list54-57-02.html)
4 Ministry of Health Labour and Welfare. Vital Statistics of Japan. 1992–2015. (http://www.mhlw.go.jp/toukei/list/81-1a.html)
5 Walker, ER, McGee, RE, Druss, BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 2015; 72: 334–41.
6 Shinozaki, H. An epidemiologic study of deaths of psychiatric inpatients. Compr Psychiatry 1976; 17: 425–36.
7 Saku, M, Ikeda, M, Kono, S, Makimoto, K, Mukai, A, Yoshimura, T. Mortality in psychiatric patients, with a specific focus on cancer mortality associated with schizophrenia. Int J Epidemiol 1995; 24: 366–72.
8 OECD. OECD Reviews of Health Care Quality: Japan. OECD, 2014 (https://www.oecd.org/els/health-systems/ReviewofHealthCareQualityJAPAN_ExecutiveSummary.pdf).
9 Thornicroft, G. Physical health disparities and mental illness: the scandal of premature mortality. Br J Psychiatry 2011; 199: 441–2.
10 Liu, NH, Daumit, GL, Dua, T, Aquila, R, Charlson, F, Cuijpers, P, et al Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World psychiatry 2017; 16: 3040.
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Premature deaths among individuals with severe mental illness after discharge from long-term hospitalisation in Japan: A naturalistic observation during a 24-year period

  • Shinsuke Kondo (a1), Yousuke Kumakura (a2), Akiko Kanehara (a3), Daisuke Nagato (a4), Taro Ueda (a4), Tsuneo Matsuoka (a4), Yukiko Tao (a4) and Kiyoto Kasai (a1)...
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