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Life Expectancy in Mental Illness
By JESSICA WARD JONES, MD, MPH Associate News Editor
Reviewed by John M. Grohol, Psy.D. on July 13, 2010
Mental illness can take years off a person’s life, but perhaps not as many as previously thought.
Recent research shows that serious and persistent mental illness can result in patients losing up to four years of life compared to individuals without mental illness.
Dr. Elizabeth E. Piatt from the Department of Behaviors and Community Health Services at Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, and her colleagues, examined death records of patients from a community mental health center, and from the general population. The researchers found an increase in premature mortality in the mentally ill patients, not only from suicide, but also cancer, accidents, liver disease and septicemia.
“We found that a community-based sample of adults with severe and persistent mental illness lost 14.5 years of potential life, a difference of 4.2 years from the (control) sample,” said Piatt.
It has been known for years that people with severe psychiatric illness have shorter lifespans, thought to be from 13.5 to 32 years shorter. More than 90 percent of suicides are as a result of a mental illness, and persons with bipolar disorder, for example, have a 10 to 20 percent lifetime risk of suicide. However, recent research has made clear that there is an increased mortality in patients with mental illness that is not directly explained by mental health issues, and is related to general medical problems.
However, most studies have tended to focus on inpatients. In addition, previous research has not directly compared years of potential life lost between mental health patients and individuals without mental illness. Thus the number of potential years of life lost may be lower than previously suggested.
“By not examining differences in premature mortality, the results of these studies may have overestimated (this outcome) in the population with serious mental illness,” note the authors.
To accurately assess the true impact of serious and persistent mental illness on years of potential life lost, Piatt and her colleagues retrospectively matched 647 case management files from patients who had been treated at a community health center prior to their deaths to 15,517 state death records from the general population.
The authors defined serious mental illness as schizophrenia and schizoaffective disorder, bipolar disorder, dysthymia, major depression, anxiety disorder and personality disorders. Individuals with dementia and substance abuse disorders were not included in the study.
They found that the mean number of years of potential life lost for decedents with serious and persistent mental illness was 14.5 (standard deviation ± 10.6) compared to 10.5 (± 6.7) for the general population. The mean age of death for the psychiatric patients was 73.4 (± 15.4) years compared to 79.6 (± 10.9) years.
Heart disease was the leading cause of death for each group. After statistical adjustments were made for gender, race, education and marital status, the greatest differences in cause of death between the two groups were seen in suicide, cancer, accidents, liver disease, and septicemia.
Differences were also seen in every leading cause of death. However, even after adjusting for all the differences in cause of death, there was still a increased number of years of potential life lost that was not explained.
“Differences in cause of death did not explain the difference in years of potential life lost,” said Piatt.
These results are important in giving a more accurate picture of the true impact of serious and persistent mental illness on life expectency, and the nature of that impact. Patients with psychiatric disorders are not only at risk for psychiatric complications, but are also at greater risk for medical illness, and at an increased risk for more complicated medical disease and worse outcomes.
Patients with psychiatric illness may be more likely to engage in risky behaviors that result in accidents, or to smoke, or be less compliant with medications. Another recent study showed that patients with bipolar disorder are at an increased risk for heart disease. Other research has shown that patients admitted to psychiatric hospitals are at risk for increased mortality from general medical problems. In addition, some psychiatric medications, notably antipsychotics, can increase the risk of diabetes, or heart disease.
Mental health practitioners have an opportunity to intervene not just in preventing suicides, but also in discouraging risky behavior, encouraging a healthy lifestyle, and general primary medical care.
“Integrating mental health care, primary health care, and wellness-promoting activities….may ensure access to the interventions needed to reverse the causes of preventable early death,” say Piatt and her team. “Morbidity and mortality from the most common causes of death in this sample…may be reduced by effective medical care that attempts prevention, early detection, and chronic disease management.”
The authors conclude: “Our work adds to the growing body of literature that highlights the need for better preventative health care for persons with mental illness. Along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on these preventable causes of death.”
Dr. Piatt’s results are published in the July issue of Psychiatric Services.
Source: Psychiatric Services
Friday, July 23, 2010
Saturday, July 17, 2010
Cognitive functioning certainly protected in some patients, including me
A gene has been found in some people with schizophrenia that can help protect cognitive ability.
While it may put individuals at risk for schizophrenia in the first place, schizophrenic patients with the at-risk gene performed better on certain tests of cognitive function than patients with a less risky variant of the same gene.
Dr. James T.R. Walters of the Medical Research Council for Neuropsychiatric Genetics and Genomics at Cardifff University in Wales, and his colleagues found preserved memory with a variation in the gene known as the Zinc Finger Protein 804A.
Prior research has implicated the Zinc Finger Protein 804A gene (ZNF804A) as a risk factor for schizophrenia. Alleles are different variations of the same gene, and one allele of the ZNF804A gene seems to be more commonly present in patients with psychiatric diagnoses such as schizophrenia and bipolar disorder. While its exact function remains elusive, some researchers suspect that the ZNF804A gene affects communication in the brain.
Walters and his team studied 297 adults with schizophrenia and 165 healthy adults in Ireland. The same research was repeated in Germany on a population of 251 patients with schizophrenia and 1472 controls to confirm the results.
All participants were genetically tested to assess which allele of the ZNF804A gene was present. Study participants also underwent tests of cognitive function including IQ, episodic memory, working memory, and attention.
Variations of the ZNF804A gene did not have any effect on the results of the cognitive testing in the adults with no psychiatric disorder.
However, in the individuals with schizophrenia, the at-risk allele of ZNF804A appeared to have a protective effect on cognitive functions such as working memory and episodic memory.
Walters then limited the results to only patients with a relatively higher IQ and the association between the at-risk gene and the preserved memory functions became even stronger.
“Although the observed association with cognition seem counterintuitive, it is important to note that the risk allele at ZNF804A is not so much associated with better cognitive performance in the present study as with less impaired cognitive performance,” writes Walters.
The exact nature between the relationship of ZNF804A and the development of schizophrenia is not entirely understood. These results are important in suggesting that ZNF804A may be a risk factor for one subtype of schizophrenia, and the development of some subtypes of schizophrenia may also involve cognitive pathways.
Further research into the genetics and the molecular biology of the development of schizophrenia could provide important information to help in diagnosis, treatment and prevention of the disease.
Dr. Walter’s results can be found in the July issue of the Archives of General Psychiatry.
Source: Archives of General Psychiatry
While it may put individuals at risk for schizophrenia in the first place, schizophrenic patients with the at-risk gene performed better on certain tests of cognitive function than patients with a less risky variant of the same gene.
Dr. James T.R. Walters of the Medical Research Council for Neuropsychiatric Genetics and Genomics at Cardifff University in Wales, and his colleagues found preserved memory with a variation in the gene known as the Zinc Finger Protein 804A.
Prior research has implicated the Zinc Finger Protein 804A gene (ZNF804A) as a risk factor for schizophrenia. Alleles are different variations of the same gene, and one allele of the ZNF804A gene seems to be more commonly present in patients with psychiatric diagnoses such as schizophrenia and bipolar disorder. While its exact function remains elusive, some researchers suspect that the ZNF804A gene affects communication in the brain.
Walters and his team studied 297 adults with schizophrenia and 165 healthy adults in Ireland. The same research was repeated in Germany on a population of 251 patients with schizophrenia and 1472 controls to confirm the results.
All participants were genetically tested to assess which allele of the ZNF804A gene was present. Study participants also underwent tests of cognitive function including IQ, episodic memory, working memory, and attention.
Variations of the ZNF804A gene did not have any effect on the results of the cognitive testing in the adults with no psychiatric disorder.
However, in the individuals with schizophrenia, the at-risk allele of ZNF804A appeared to have a protective effect on cognitive functions such as working memory and episodic memory.
Walters then limited the results to only patients with a relatively higher IQ and the association between the at-risk gene and the preserved memory functions became even stronger.
“Although the observed association with cognition seem counterintuitive, it is important to note that the risk allele at ZNF804A is not so much associated with better cognitive performance in the present study as with less impaired cognitive performance,” writes Walters.
The exact nature between the relationship of ZNF804A and the development of schizophrenia is not entirely understood. These results are important in suggesting that ZNF804A may be a risk factor for one subtype of schizophrenia, and the development of some subtypes of schizophrenia may also involve cognitive pathways.
Further research into the genetics and the molecular biology of the development of schizophrenia could provide important information to help in diagnosis, treatment and prevention of the disease.
Dr. Walter’s results can be found in the July issue of the Archives of General Psychiatry.
Source: Archives of General Psychiatry
Monday, July 5, 2010
Severe brain disease
Schizophrenia Is A Severe Mental Disease.
All over the world around 1 in 100 people will develop Schizophrenia during their lifetime. There are quite a lot types of Schizophrenia.
In suspicious schizophrenia the patient has delusions and auditory hallucinations. Read more Stenslag reparation
Very often the delusions are about being mistreated unfairly or being some other person who is eminent.
Symptoms of Schizophrenia are mainly disturbances of thought processes but also extend to disturbances of behavior and emotion.
Schizophrenia means split mind or divided self. In such cases the nature loses its unity.
Individuals suffering from Schizophrenia can display anger, unfriendliness, anxiety and argumentativeness.
Social withdrawal, extreme anxiety and a feeling of being unreal, a sense of being controlled by external forces are behavioral changes that can take place in a person suffering from schizophrenia. They incline to also make up words without a meaning.
Schizophrenia makes it difficult for a person to tell the difference between real and unreal experiences, to think logically or to have proper, emotional responses to others. They are also unable to behave appropriately in social positions.
Antipsychotic medications have been available since the mid-1950s.
These medications shrink the psychotic symptoms of Schizophrenic and usually allow the patient to function more successfully and appropriately.
Psychotherapy is not a supplementary for antipsychotic medication. Read more Boern og kost
The schizophrenic patients feel rejected, despised, detested in their significant interpersonal relationships.
A Schizophrenic patient ought to definitely get support from the family, doctor, counselor and friends.
Genetics, early environment, neurobiology, psychological and social procedures are said to be important contributory factors to schizophrenia.
Symptoms of schizophrenia can be caused or worsened by some amusing and prescription drugs.
Late adolescence and early adulthood are highest years for the onset of schizophrenia.
Schizophrenia is often described in terms of positive and negative symptoms. Positive symptoms refer to symptoms that is present in schizophrenia. This includes delusions, auditory, hallucinations and thought disorder.
Harmful symptoms include flat emotion, poverty of speech, inability to experience pleasure and lack of want to form relationships.
Negative symptoms contribute more to poor excellence of life and functional disability.
It has been suggested that Schizophrenia is a form of complex inheritance, with many different potential genes each of small consequence, with different pathways for different individuals. Read more Palaevilla
A interesting finding has been done relating to schizophrenia and that is in the northern hemisphere people diagnosed with schizophrenia are more probable to have been born in winter or spring.
About the Author:
www.ledgaardstyropor.dk
All over the world around 1 in 100 people will develop Schizophrenia during their lifetime. There are quite a lot types of Schizophrenia.
In suspicious schizophrenia the patient has delusions and auditory hallucinations. Read more Stenslag reparation
Very often the delusions are about being mistreated unfairly or being some other person who is eminent.
Symptoms of Schizophrenia are mainly disturbances of thought processes but also extend to disturbances of behavior and emotion.
Schizophrenia means split mind or divided self. In such cases the nature loses its unity.
Individuals suffering from Schizophrenia can display anger, unfriendliness, anxiety and argumentativeness.
Social withdrawal, extreme anxiety and a feeling of being unreal, a sense of being controlled by external forces are behavioral changes that can take place in a person suffering from schizophrenia. They incline to also make up words without a meaning.
Schizophrenia makes it difficult for a person to tell the difference between real and unreal experiences, to think logically or to have proper, emotional responses to others. They are also unable to behave appropriately in social positions.
Antipsychotic medications have been available since the mid-1950s.
These medications shrink the psychotic symptoms of Schizophrenic and usually allow the patient to function more successfully and appropriately.
Psychotherapy is not a supplementary for antipsychotic medication. Read more Boern og kost
The schizophrenic patients feel rejected, despised, detested in their significant interpersonal relationships.
A Schizophrenic patient ought to definitely get support from the family, doctor, counselor and friends.
Genetics, early environment, neurobiology, psychological and social procedures are said to be important contributory factors to schizophrenia.
Symptoms of schizophrenia can be caused or worsened by some amusing and prescription drugs.
Late adolescence and early adulthood are highest years for the onset of schizophrenia.
Schizophrenia is often described in terms of positive and negative symptoms. Positive symptoms refer to symptoms that is present in schizophrenia. This includes delusions, auditory, hallucinations and thought disorder.
Harmful symptoms include flat emotion, poverty of speech, inability to experience pleasure and lack of want to form relationships.
Negative symptoms contribute more to poor excellence of life and functional disability.
It has been suggested that Schizophrenia is a form of complex inheritance, with many different potential genes each of small consequence, with different pathways for different individuals. Read more Palaevilla
A interesting finding has been done relating to schizophrenia and that is in the northern hemisphere people diagnosed with schizophrenia are more probable to have been born in winter or spring.
About the Author:
www.ledgaardstyropor.dk
Friday, July 2, 2010
Rushing Thoughts Yet To Subside
6/30/10 11:34am
I try all the time, and push myself to be the best man that I can be. I think that I am a good father and husband to Heather and Tyler. Now that we are having another child, I feel like I am shot out of a cannon. Spring and summer seem to be the bane of my existence. Usually in the Spring and Summer, I must admit, I feel more manic, psychotic and disturbing thoughts that shoot through my brain like a razor wire moving at the speed of light. I cannot ever, when I feel manic, turn my brain on silent. Sorry, Shea's thoughts are not available right now, but if you leave a message at the tone, he'll be sure to consider getting back to you when he gets back into the office. But no, I do not have the luxury, nor the extra money to take any time off work, home or life in general. Nay, I must suffer through the worst of it, with the very stimuli that cause my rushing thoughts all around me all the time.
6/30/10 4:54 PM
And now, just as quickly as the hastening thoughts had arisen, they calm down, as if to say, as you wish, for now. I know that as uncomfortable as these thoughts are, as a quickly approaching thunder storm in the middle of July, they pass and a calm sets in. This period, though I know is temporary, comes on and is marked by low thought volume in my mind and flat emotions. Whereas when I am feeling at the height of my mania, I could never take a nap, during these periods of calm, I feel I must, at times, take a few winks.
I try all the time, and push myself to be the best man that I can be. I think that I am a good father and husband to Heather and Tyler. Now that we are having another child, I feel like I am shot out of a cannon. Spring and summer seem to be the bane of my existence. Usually in the Spring and Summer, I must admit, I feel more manic, psychotic and disturbing thoughts that shoot through my brain like a razor wire moving at the speed of light. I cannot ever, when I feel manic, turn my brain on silent. Sorry, Shea's thoughts are not available right now, but if you leave a message at the tone, he'll be sure to consider getting back to you when he gets back into the office. But no, I do not have the luxury, nor the extra money to take any time off work, home or life in general. Nay, I must suffer through the worst of it, with the very stimuli that cause my rushing thoughts all around me all the time.
6/30/10 4:54 PM
And now, just as quickly as the hastening thoughts had arisen, they calm down, as if to say, as you wish, for now. I know that as uncomfortable as these thoughts are, as a quickly approaching thunder storm in the middle of July, they pass and a calm sets in. This period, though I know is temporary, comes on and is marked by low thought volume in my mind and flat emotions. Whereas when I am feeling at the height of my mania, I could never take a nap, during these periods of calm, I feel I must, at times, take a few winks.
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