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Combating Early Death in People with Serious Mental Illness

Science Update

A recent article  and commentary  in JAMA Psychiatry contain some disturbing statistics about early death for people with serious mental illness (SMI). Mark Olfson’s team followed a group of 1.1 million people with schizophrenia and found that, during the study period, they were more than 3.5 times more likely to die than the general population. These individuals are estimated to be losing 28.5 years of life, primarily because of natural causes. Eighty-five percent of the premature deaths were due to largely preventable conditions such as high blood pressure, high cholesterol, diabetes, and heart disease.

Premature death among people with SMI, including schizophrenia, has been recognized for some time. It is also known that unhealthy lifestyle behaviors such as poor diet, lack of exercise, and smoking contribute to many of their physical problems. People with schizophrenia are much more likely to smoke than people with no mental illness.

The Olfson et al. paper and the accompanying commentary identify the need to concentrate on risk factors related to unhealthy lifestyle, the need to treat these health risk factors, and the need to manage physical illnesses that are common in people with schizophrenia such as diabetes and heart disease.

What is NIMH doing about this issue? Several years ago, NIMH launched a large research initiative on ways to prevent and treat these health problems in people with schizophrenia and other SMIs. Currently, the institute funds more than a dozen studies to accomplish that goal. These studies focus mainly on cardiometabolic problems, problems that affect the heart and blood and contribute to early mortality.

Dr. Susan Azrin, program chief of the Primary Care Research Program in NIMH’s Division of Services and Intervention Research, says, “The premature death of people with SMI, due mainly to preventable causes, is a tremendous public health concern. Effective strategies to reduce common health risk factors, such as high blood pressure, poor diet and fitness, and smoking, are available to the general population. We need to figure out how to make these effective strategies available to people with SMIs at the earliest opportunity.”

NIMH’s newest research effort aims to reach people with SMI earlier in life, before these dangerous health problems take hold. In 2016, NIMH will support up to five new research projects that develop and test new approaches for reducing cardiometabolic risks in youth with serious emotional disturbance and young adults with serious mental illness.