A retrospective and comprehensive analysis of excess life-years lost, mortality risk, and cause of death among severe mental illness in China

作者：Xinyu Fang, Hao Yu, Chaoran Wu, Junhua Tan, Feng Sun, Ning Qian, Hui Zhou, Jinyi Zhou, Xiangrong Zhang · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-025-04380-9 · 被引用次数：4 · 研究领域：Schizophrenia research and treatment、Bipolar Disorder and Treatment、Tryptophan and brain disorders

BACKGROUND: Individuals with severe mental illness (SMI) experience higher mortality rates than the general population. We conducted a comprehensive, population-based study to quantify the excess life-years lost (LYLs), mortality risks, and cause of death among SMIs. METHODS: Using data from the Jiangsu Province Management Information System for Patients with SMI, we identified 321,436 SMI patients in Jiangsu, China, between January 2014 and December 2022; 33,947 of them died during follow-up. We calculated the excess LYLs for each type of SMI and estimated the standardized mortality ratios (SMRs) for all-cause and specific-cause mortality among individuals with four types of SMIs. RESULTS: The excess LYLs in four types of SMIs were as follows: for schizophrenia, 12.87 years in males and 11.92 years in females; for bipolar disorder, 8.43 years in males and 5.54 years in females; for paranoid disorder, 13.90 years in males and 14.03 years in females; and for schizoaffective disorder, 16.69 years in males and 15.82 years in females, when compared to the general population. Individuals with SMI had nearly twice the all-cause mortality of the general population (adjusted SMR 1.96, 95% CI 1.94-1.98). Elevated mortality rates were observed across all types of SMIs, with SMRs varying from 1.23 to 2.96. The SMRs for specific causes showed distinct patterns, with infectious diseases ranging from 1.60 to 3.08, neoplasms from 0.73 to 1.15, diabetes from 1.82 to 3.89, nervous system dise...