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Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia

  • Abebaw Fekadu (a1), Girmay Medhin (a2), Derege Kebede (a3), Atalay Alem (a4), Anthony J. Cleare (a5), Martin Prince (a6), Charlotte Hanlon (a4) and Teshome Shibre (a4)...

Abstract

Background

Evidence on mortality in severe mental illness (SMI) comes primarily from clinical samples in high-income countries.

Aims

To describe mortality in people with SMI among a population cohort from a low-income country.

Method

We followed-up 919 adults (from 68 378 screened) with SMI over 10 years. Standardised mortality ratios (SMR) and years of life lost (YLL) as a result of premature mortality were calculated.

Results

In total 121 patients (13.2%) died. The overall SMR was twice that of the general population; higher for men and people with schizophrenia. Patients died about three decades prematurely, mainly from infectious causes (49.6%). Suicide, accidents and homicide were also common causes of death.

Conclusions

Mortality is an important adverse outcome of SMI irrespective of setting. Addressing common natural and unnatural causes of mortality are urgent priorities. Premature death and mortality related to self-harm should be considered in the estimation of the global burden of disease for SMI.

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Copyright

Corresponding author

Abebaw Fekadu, Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, PO Box 9086, Addis Ababa, Ethopia. Email: abe.wassie@kcl.ac.uk

Footnotes

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Declaration of interest

None.

Footnotes

References

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Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia

  • Abebaw Fekadu (a1), Girmay Medhin (a2), Derege Kebede (a3), Atalay Alem (a4), Anthony J. Cleare (a5), Martin Prince (a6), Charlotte Hanlon (a4) and Teshome Shibre (a4)...

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Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia

  • Abebaw Fekadu (a1), Girmay Medhin (a2), Derege Kebede (a3), Atalay Alem (a4), Anthony J. Cleare (a5), Martin Prince (a6), Charlotte Hanlon (a4) and Teshome Shibre (a4)...
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