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Plana-Ripoll O, Musliner KL, Dalsgaard S, et al. Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study. World Psychiatry. 2020;19(3):339-349doi: 10.1002/wps.20802.
Plana-Ripoll, O., Musliner, K. L., Dalsgaard, S., Momen, N. C., Weye, N., Christensen, M. K., Agerbo, E., Iburg, K. M., Laursen, T. M., Mortensen, P. B., Pedersen, C. B., Petersen, L. V., Santomauro, D. F., Vilhjálmsson, B. J., Whiteford, H. A., & McGrath, J. J. (2020). Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study. World psychiatry : official journal of the World Psychiatric Association (WPA), 19(3), 339-349. https://doi.org/10.1002/wps.20802
Plana-Ripoll, Oleguer, et al. "Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study." World psychiatry : official journal of the World Psychiatric Association (WPA) vol. 19,3 (2020): 339-349. doi: https://doi.org/10.1002/wps.20802
Plana-Ripoll O, Musliner KL, Dalsgaard S, Momen NC, Weye N, Christensen MK, Agerbo E, Iburg KM, Laursen TM, Mortensen PB, Pedersen CB, Petersen LV, Santomauro DF, Vilhjálmsson BJ, Whiteford HA, McGrath JJ. Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study. World Psychiatry. 2020 Oct;19(3):339-349. doi: 10.1002/wps.20802. PMID: 32931098; PMCID: PMC7491620.
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World Psychiatry. 2020 Oct;19(3):339-349. doi: 10.1002/wps.20802.

Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study.

World psychiatry : official journal of the World Psychiatric Association (WPA)

Oleguer Plana-Ripoll, Katherine L Musliner, Søren Dalsgaard, Natalie C Momen, Nanna Weye, Maria K Christensen, Esben Agerbo, Kim Moesgaard Iburg, Thomas Munk Laursen, Preben Bo Mortensen, Carsten Bøcker Pedersen, Liselotte Vogdrup Petersen, Damian F Santomauro, Bjarni J Vilhjálmsson, Harvey A Whiteford, John J McGrath

Affiliations

  1. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
  2. Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.
  3. Department of Public Health, Aarhus University, Aarhus, Denmark.
  4. Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark.
  5. Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark.
  6. Queensland Centre for Mental Health Research, Wacol, QLD, Australia.
  7. School of Public Health, University of Queensland, Brisbane, QLD, Australia.
  8. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
  9. Queensland Brain Institute, University of Queensland, St. Lucia, QLD, Australia.

PMID: 32931098 PMCID: PMC7491620 DOI: 10.1002/wps.20802

Abstract

The nature and prevalence of combinations of mental disorders and their associations with premature mortality have never been reported in a comprehensive way. We describe the most common combinations of mental disorders and estimate excess mortality associated with these combinations. We designed a population-based cohort study including all 7,505,576 persons living in Denmark at some point between January 1, 1995 and December 31, 2016. Information on mental disorders and mortality was obtained from national registers. A total of 546,090 individuals (10.5%) living in Denmark on January 1, 1995 were diagnosed with at least one mental disorder during the 22-year follow-up period. The overall crude rate of diagnosis of mental disorders was 9.28 (95% CI: 9.26-9.30) per 1,000 person-years. The rate of diagnosis of additional mental disorders was 70.01 (95% CI: 69.80-70.26) per 1,000 person-years for individuals with one disorder already diagnosed. At the end of follow-up, two out of five individuals with mental disorders were diagnosed with two or more disorder types. The most prevalent were neurotic/stress-related/somatoform disorders (ICD-10 F40-F48) and mood disorders (ICD-10 F30-F39), which - alone or in combination with other disorders - were present in 64.8% of individuals diagnosed with any mental disorder. Mortality rates were higher for people with mental disorders compared to those without mental disorders. The highest mortality rate ratio was 5.97 (95% CI: 5.52-6.45) for the combination of schizophrenia (ICD-10 F20-F29), neurotic/stress-related/somatoform disorders and substance use disorders (ICD-10 F10-F19). Any combination of mental disorders was associated with a shorter life expectancy compared to the general Danish population, with differences in remaining life expectancy ranging from 5.06 years (95% CI: 5.01-5.11) to 17.46 years (95% CI: 16.86-18.03). The largest excess mortality was observed for combinations that included substance use disorders. This study reports novel estimates related to the "force of comorbidity" and provides new insights into the contribution of substance use disorders to premature mortality in those with comorbid mental disorders.

© 2020 World Psychiatric Association.

Keywords: Mental disorders; comorbidity; life expectancy; mood disorders; mortality; neurotic/stress-related/somato-form disorders; schizophrenia; substance use disorders

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