This is an outdated version published on 2025-11-21. Read the most recent version.

Premature death in psychiatric patients, a true enigma

Authors

  • Jenniffer Katerin Merchán Restrepo Universidad de Ciencias Aplicadas y Ambientales
  • Vanessa Paulina Valle Molinares Universidad Nacional de Colombia
  • Diana Ximena Lara Rodríguez Fundació Universitaria Juan N. Corpas
  • David Steven Cañón Ramirez Fundación Universitaria de Ciencias de la Salud
  • Manuela Suárez Hernández Universidad El Bosque

Abstract

Psychiatric disorders are an alteration of cognitive, affective and behavioral status, which are capable of enhancing the functioning of an individual. People who have a mental disorder throughout their lives are at increased risk of morbidity and mortality from different causes.
The analysis of years of life lost secondary to mental disorders has had a strong correlation with self-inflicted injuries and unintentional injuries, which are also associated with the age of diagnosis and psychiatric and somatic pre-existences.
The disorders mostly associated with psychiatric coexistence that generate an increase in mortality are eating disorders, alcohol use disorders and psychoactive substance abuse disorders.
In this review, we will address the causes of premature mortality in different psychiatric disorders.

References

American Psychiatric association. (2014). Diagnostic and statistical Manual of Mental Disorders. Ed. Panamericana.

Organización Mundial de la Salud. (17 de junio del 2022). La OMS subraya la urgencia de transformar la salud mental y los cuidados conexos. https://www.who.int/es/news/item/17-06-2022-who-highlights-urgent-need-to-transform-mental-health-and-mental-health-care

Ministerio de salud y protección social. (10 de octubre del 2022). Salud mental: asunto de todos. https://www.minsalud.gov.co/Paginas/Salud-mental-asunto-de-todos.aspx

Weye, N., Momen, N. C., Christensen, M. K., Iburg, K. M., Dalsgaard, S., Laursen, T. M., Mortensen, P. B., Santomauro, D. F., Scott, J. G., Whiteford, H. A., McGrath, J. J., & Plana-Ripoll, O. (2020). Association of Specific Mental Disorders with Premature Mortality in the Danish Population Using Alternative Measurement Methods. JAMA Network Open, 3(6). https://doi.org/10.1001/jamanetworkopen.2020.6646

Dome, P., Rihmer, Z., & Gonda, X. (2019). Suicide risk in bipolar disorder: A brief review. In Medicina (Lithuania) (Vol. 55, Issue 8). MDPI AG. https://doi.org/10.3390/medicina55080403

Leone, M., Kuja-Halkola, R., Leval, A., D’Onofrio, B. M., Larsson, H., Lichtenstein, P., & Bergen, S. E. (2021). Association of Youth Depression with Subsequent Somatic Diseases and Premature Death. JAMA Psychiatry, 78(3), 302–310. https://doi.org/10.1001/jamapsychiatry.2020.3786

Momen, N. C., Plana-Ripoll, O., Agerbo, E., Christensen, M. K., Iburg, K. M., Laursen, T. M., Mortensen, P. B., Pedersen, C. B., Prior, A., Weye, N., & McGrath, J. J. (2022). Mortality Associated with Mental Disorders and Comorbid General Medical Conditions. JAMA Psychiatry, 79(5), 444–453. https://doi.org/10.1001/jamapsychiatry.2022.0347

Weye, N., Momen, N. C., Christensen, M. K., Iburg, K. M., Dalsgaard, S., Laursen, T. M., Mortensen, P. B., Santomauro, D. F., Scott, J. G., Whiteford, H. A., McGrath, J. J., & Plana-Ripoll, O. (2020). Association of Specific Mental Disorders with Premature Mortality in the Danish Population Using Alternative Measurement Methods. JAMA Network Open, 3(6). https://doi.org/10.1001/jamanetworkopen.2020.6646

Plana-Ripoll, O., Pedersen, C. B., Agerbo, E., Holtz, Y., Erlangsen, A., Canudas-Romo, V., Andersen, P. K., Charlson, F. J., Christensen, M. K., Erskine, H. E., Ferrari, A. J., Iburg, K. M., Momen, N., Mortensen, P. B., Nordentoft, M., Santomauro, D. F., Scott, J. G., Whiteford, H. A., Weye, N., ... Laursen, T. M. (2019). A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study. The Lancet, 394(10211), 1827–1835. https://doi.org/10.1016/S0140-6736(19)32316-5

Kuo, C. J., Chen, W. Y., Tsai, S. Y., Chen, P. H., Ko, K. T., & Chen, C. C. (2019). Excessive mortality and causes of death among patients with personality disorder with comorbid psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology, 54(1), 121–130. https://doi.org/10.1007/s00127-018-1587-x

Sariaslan, A., Sharpe, M., Larsson, H., Wolf, A., Lichtenstein, P., & Fazel, S. (2022). Psychiatric comorbidity and risk of premature mortality and suicide among those with chronic respiratory diseases, cardiovascular diseases, and diabetes in Sweden: A nationwide matched cohort study of over 1 million patients and their unaffected siblings. PloS Medicine, 19(1). https://doi.org/10.1371/journal.pmed.1003864

Penninx, B. W. J. H., Sjors, ;, & Lange, M. M. (2018). Metabolic syndrome in psychiatric patients: overview, mechanisms, and implications. www.dialogues-cns.org

Θεοδόσης-Νόμπελος, Π., Ασημακοπούλου, Ε., & Μαδιανός, Μ. (n.d.). Παθοφυσιολογικοί μηχανισμοί μειζόνων ψυχικών διαταραχών εμπλεκόμενοι στην ανάπτυξη καρδιαγγειακών νοσημάτων. https://doi.org/10.22365/jpsych.2021.038/Psychiatriki

Bai, W., Liu, Z. H., Jiang, Y. Y., Zhang, Q. E., Rao, W. W., Cheung, T., Hall, B. J., & Xiang, Y. T. (2021). Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys. In Translational Psychiatry (Vol. 11, Issue 1). Springer Nature.

Dong, M., Wang, S. B., Wang, F., Zhang, L., Ungvari, G. S., Ng, C. H., Meng, X., Yuan, Z., Wang, G., & Xiang, Y. T. (2019). Suicide-related behaviours in schizophrenia in China: A comprehensive meta-analysis. Epidemiology and Psychiatric Sciences, 28(3), 290–299. https://doi.org/10.1017/S2045796017000476

Challa, F., Getahun, T., Sileshi, M., Geto, Z., Kelkile, T. S., Gurmessa, S., Medhin, G., Mesfin, M., Alemayehu, M., Shumet, T., Mulugeta, A., Bekele, D., Borba, C. P. C., Oppenheim, C. E., Henderson, D. C., Fekadu, A., Carobene, A., & Teferra, S. (2021). Prevalence of metabolic syndrome among patients with schizophrenia in Ethiopia. BMC Psychiatry, 21(1). https://doi.org/10.1186/s12888-021-03631-2

Rastogi, A., Viani-Walsh, D., Akbari, S., Gall, N., Gaughran, F., & Lally, J. (2020). Pathogenesis and management of Brugada syndrome in schizophrenia: A scoping review. In General Hospital Psychiatry (Vol. 67, pp. 83–91). Elsevier Inc.

Yung, N. C. L., Wong, C. S. M., Chan, J. K. N., & Chang, W. C. (2022). Mortality rates in people with first diagnosis of schizophrenia-spectrum disorders: A 5-year population-based cohort study. Australian and New Zealand Journal of Psychiatry.

Yung, N. C. L., Wong, C. S. M., Chan, J. K. N., Chen, E. Y. H., & Chang, W. C. (2021). Excess Mortality and Life-Years Lost in People with Schizophrenia and Other Non-affective Psychoses: An 11-Year Population-Based Cohort Study. Schizophrenia Bulletin, 47(2), 474–484. https://doi.org/10.1093/schbul/sbaa137

Laursen, T. M. (2019). Causes of premature mortality in schizophrenia: A review of literature published in 2018. In Current Opinion in Psychiatry (Vol. 32, Issue 5, pp. 388–393). Lippincott Williams and Wilkins. https://doi.org/10.1097/YCO.0000000000000530

Atagün, M. İ., & Oral, T. (2021). Acute and long term treatment of manic episodes in bipolar disorder. In Noropsikiyatri Arsivi (Vol. 58, pp. S24–S30). Turkish Neuropsychiatric Society. https://doi.org/10.29399/npa.27411

Chan, J. K. N., Tong, C. C. H. Y., Wong, C. S. M., Chen, E. Y. H., & Chang, W. C. (2022). Life expectancy and years of potential life lost in bipolar disorder: systematic review and meta-analysis. In British Journal of Psychiatry (221)3:567-76. Cambridge University Press.

Yung, N. C. L., Wong, C. S. M., Chan, J. K. N., Chen, E. Y. H., & Chang, W. C. (2021). Excess Mortality and Life-Years Lost in People with Schizophrenia and Other Non-affective Psychoses: An 11-Year Population-Based Cohort Study. Schizophrenia Bulletin, 47(2), 474–484. https://doi.org/10.1093/schbul/sbaa137

Serretti, A., & Porcelli, S. (2018). Antidepressant induced weight gain. In BMJ (Online) (Vol. 361). BMJ Publishing Group. https://doi.org/10.1136/bmj.k2151

Penninx, B. W. J. H., Sjors, ;, & Lange, M. M. (2018). Metabolic syndrome in psychiatric patients: overview, mechanisms, and implications. www.dialogues-cns.org

Vieta, E., Alonso, J., Pérez-Sola, V., Roca, M., Hernando, T., Sicras-Mainar, A., Sicras-Navarro, A., Herrera, B., & Gabilondo, A. (2021). Epidemiology and costs of depressive disorder in Spain: the EPICO study. European Neuropsychopharmacology, 50, 93–103. https://doi.org/10.1016/j.euroneuro.2021.04.022

Walter, F., Carr, M. J., Mok, P. L. H., Antonsen, S., Pedersen, C. B., Shaw, J., & Webb, R. T. (2018). Suicide methods and specific types of accidental death and fatal poisoning among discharged psychiatric patients: A national cohort study. Journal of Clinical Psychiatry, 79(6). https://doi.org/10.4088/JCP.17m11809

Mutz, J., Choudhury, U., Zhao, J., & Dregan, A. (2022). Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality. BMC Medicine, 20(1), 274. https://doi.org/10.1186/s12916-022-02474-2

Chen, P. H., Tsai, S. Y., Pan, C. H., Chang, H. M., Chen, Y. L., Su, S. S., Chen, C. C., & Kuo, C. J. (2020). Incidence and risk factors of sudden cardiac death in bipolar disorder across the lifespan. Journal of Affective Disorders, 274, 210–217. https://doi.org/10.1016/j.jad.2020.05.094

DeJongh, B. M. (2021). Clinical pearls for the monitoring and treatment of antipsychotic induced metabolic syndrome. Mental Health Clinician, 11(6), 311–319. https://doi.org/10.9740/MHC.2021.11.311

Atagün, M. İ., & Oral, T. (2021). Acute and long term treatment of manic episodes in bipolar disorder. In Noropsikiyatri Arsivi (Vol. 58, pp. S24–S30). Turkish Neuropsychiatric Society. https://doi.org/10.29399/npa.27411

Osborn, D. P. J., Marston, L., Nazareth, I., King, M. B., Petersen, I., & Walters, K. (2017). Relative risks of cardiovascular disease in people prescribed olanzapine, risperidone and quetiapine. Schizophrenia Research, 183, 116–123. https://doi.org/10.1016/j.schres.2016.11.009

DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of Internal Medicine, 170(7), ITC49–ITC64. https://doi.org/10.7326/AITC201904020

Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. (2022). The Lancet Psychiatry, 9(2), 137–150. https://doi.org/10.1016/S2215-0366(21)00395-3

Chang, H. M., Pan, C. H., Chen, P. H., Chen, Y. L., Su, S. S., Tsai, S. Y., Chen, C. C., & Kuo, C. J. (2022). Premature death and causes of death among patients with panic disorder and comorbid psychiatric disorders: A nationwide cohort study. Journal of Psychiatric Research, 148, 340–347. https://doi.org/10.1016/j.jpsychires.2022.02.006

Krupchanka, D., Chrtková, D., Vítková, M., Munzel, D., Čihařová, M., Růžičková, T., Winkler, P., Janoušková, M., Albanese, E., & Sartorius, N. (2018). Experience of stigma and discrimination in families of persons with schizophrenia in the Czech Republic. Social Science and Medicine, 212, 129–135. https://doi.org/10.1016/j.socscimed.2018.07.015

Chang, H. M., Pan, C. H., Chen, P. H., Chen, Y. L., Tai, M. H., Su, S. S., Tsai, S. Y., Chen, C. C., & Kuo, C. J. (2020). Sex differences in incidence and psychiatric comorbidity for alcohol dependence in patients with panic disorder. Drug and Alcohol Dependence, 207. https://doi.org/10.1016/j.drugalcdep.2019.107814

Davies, S. J. C., Iwajomo, T., de Oliveira, C., Versloot, J., Reid, R. J., & Kurdyak, P. (2021). The impact of psychiatric and medical comorbidity on the risk of mortality: A population-based analysis. Psychological Medicine, 51(2), 320–328. https://doi.org/10.1017/S003329171900326X

Dreier, J. W., Pedersen, C. B., Cotsapas, C., & Christensen, J. (2019). Childhood seizures and risk of psychiatric disorders in adolescence and early adulthood: a Danish nationwide cohort study. The Lancet Child and Adolescent Health, 3(2), 99–108. https://doi.org/10.1016/S2352-4642(18)30351-1

Khalifa, N. R., Gibbon, S., Völlm, B. A., Cheung, N. H. Y., & McCarthy, L. (2020). Pharmacological interventions for antisocial personality disorder. In Cochrane Database of Systematic Reviews (Vol. 2020, Issue 9). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD007667.pub3

Kuo, C. J., Chen, W. Y., Tsai, S. Y., Chen, P. H., Ko, K. T., & Chen, C. C. (2019). Excessive mortality and causes of death among patients with personality disorder with comorbid psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology, 54(1), 121–130. https://doi.org/10.1007/s00127-018-1587-x

Sun, S., Kuja-Halkola, R., Faraone, S. v., D’Onofrio, B. M., Dalsgaard, S., Chang, Z., & Larsson, H. (2019). Association of Psychiatric Comorbidity with the Risk of Premature Death among Children and Adults with Attention-Deficit/Hyperactivity Disorder. JAMA Psychiatry, 76(11), 1141–1149. https://doi.org/10.1001/jamapsychiatry.2019.1944

Schiavone, N., Virta, M., Leppämäki, S., Launes, J., Vanninen, R., Tuulio-Henriksson, A., Järvinen, I., Lehto, E., Michelsson, K., & Hokkanen, L. (2022). Mortality in individuals with childhood ADHD or subthreshold symptoms – a prospective perinatal risk cohort study over 40 years. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03967-3

Luderer, M., Kaplan-Wickel, N., Richter, A., Reinhard, I., Kiefer, F., & Weber, T. (2019). Screening for adult attention-deficit/hyperactivity disorder in alcohol dependent patients: Underreporting of ADHD symptoms in self-report scales. Drug and Alcohol Dependence, 195, 52–58. https://doi.org/10.1016/j.drugalcdep.2018.11.020

Arican, I., Bass, N., Neelam, K., Wolfe, K., McQuillin, A., & Giaroli, G. (2019). Prevalence of attention deficit hyperactivity disorder symptoms in patients with schizophrenia. Acta Psychiatrica Scandinavica, 139(1), 89–96. https://doi.org/10.1111/acps.12948

Luderer, M., Kaplan-Wickel, N., Richter, A., Reinhard, I., Kiefer, F., & Weber, T. (2019). Screening for adult attention-deficit/hyperactivity disorder in alcohol dependent patients: Underreporting of ADHD symptoms in self-report scales. Drug and Alcohol Dependence, 195, 52–58. https://doi.org/10.1016/j.drugalcdep.2018.11.020

Fridell, M., Bäckström, M., Hesse, M., Krantz, P., Perrin, S., & Nyhlén, A. (2019). Prediction of psychiatric comorbidity on premature death in a cohort of patients with substance use disorders: A 42-year follow-up. BMC Psychiatry, 19(1).

Day, E., & Rudd, J. H. F. (2019). Alcohol use disorders and the heart. Addiction, 114(9), 1670–1678. https://doi.org/10.1111/add.14703

Park, S., Rim, S. J., Jo, M. K., Lee, M. G., & Kim, C. E. (2019). Comorbidity of Alcohol Use and Other Psychiatric Disorders and Suicide Mortality: Data from the South Korean National Health Insurance Cohort, 2002 to 2013. Alcoholism: Clinical and Experimental Research, 43(5), 842–849. https://doi.org/10.1111/acer.13989

Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. In Sci. Adv (Vol. 5).

Luderer, M., Kaplan-Wickel, N., Richter, A., Reinhard, I., Kiefer, F., & Weber, T. (2019). Screening for adult attention-deficit/hyperactivity disorder in alcohol dependent patients: Underreporting of ADHD symptoms in self-report scales. Drug and Alcohol Dependence, 195, 52–58. https://doi.org/10.1016/j.drugalcdep.2018.11.020

Pohl, K., Moodley, P., & Dhanda, A. D. (2021). Alcohol’s impact on the gut and liver. In Nutrients (Vol. 13, Issue 9). MDPI. https://doi.org/10.3390/nu1309317053. Chikritzhs, T., & Livingston, M. (2021). Alcohol and the risk of injury. In Nutrients (Vol. 13, Issue 8). MDPI. https://doi.org/10.3390/nu13082777

Published

2023-02-23 — Updated on 2025-11-21

Versions

How to Cite

Merchán Restrepo, J. K., Valle Molinares, V. P., Lara Rodríguez, D. X., Cañón Ramirez, D. S., & Suárez Hernández, M. (2025). Premature death in psychiatric patients, a true enigma. Scientific and Educational Medical Journal, 2(3), 5 - 18. Retrieved from https://medicaljournal.com.co/index.php/mj/article/view/104 (Original work published February 23, 2023)

Most read articles by the same author(s)