Risks of all-cause and suicide mortality in mental disorders: a meta-review.
Level 1 - systematic review of randomized trials
Systematic review (umbrella review) synthesizing systematic reviews of observational and cohort mortality data.
PubMed 24890068 · doi:10.1002/wps.20128
What was done
A systematic meta-review was conducted across literature databases to evaluate all-cause and suicide mortality across major mental disorders. From an initial pool of 407 relevant reviews, 20 systematic reviews examining 20 distinct mental disorders met inclusion criteria, encompassing data from over 1.7 million patients and more than 250,000 deaths.
What was found
All evaluated mental disorders exhibited an increased risk of all-cause mortality relative to the general population, with effect sizes often exceeding or matching those associated with heavy smoking. Substance use disorders and anorexia nervosa had the highest all-cause mortality ratios, corresponding to an estimated reduction in life expectancy of 10 to 20 years. Borderline personality disorder, anorexia nervosa, depression, and bipolar disorder demonstrated the highest suicide risks. Specific summary numerical risk ratios and confidence intervals were not reported in the abstract.
Why it matters
This synthesis demonstrates that premature mortality and suicide are pervasive across psychiatric diagnoses, highlighting an urgent need for clinical interventions and public health strategies targeting physical health and suicide prevention in psychiatric populations.
Limits
The abstract notes that the methodological quality of the included systematic reviews was typically low and that notable literature gaps remain. Numerical effect estimates and specific measures of heterogeneity were not reported in the abstract.
Cited by
- context Anorexia nervosa is the most dangerous and deadly psychiatric illness of all psychiatric disorders.