Targeting Unhealthy Lifestyles May Increase Longevity in Those With Severe Mental Illness

Addressing unhealthy lifestyle factors among people with severe mental illness could potentially provide the greatest benefit in increasing life expectancy, according to a new U.K. study conducted by researchers at King’s College London.

Severe mental illnesses include schizophrenia, schizoaffective disorder, bipolar disorder and major depression.

In particular, the study found that interventions designed to help schizophrenia patients quit smoking and approaches to help lessen sedentary behavior among patients with bipolar disorder appear to be the most promising ways to increase life expectancy, showing an increase of 2 years 5 months and an increase of one year 3 months, respectively.

Currently, people with severe mental illness tend to live on average 12 to 15 years less than those in the general population. For example, 80% of deaths in patients with severe mental illness are caused by common diseases such as heart disease, respiratory illnesses, diabetes, cancer and digestive disorders.

All of these diseases can be at least partly attributed to unhealthy lifestyle factors, social isolation and deprivation, and inadequate use of healthcare services.

To help inform public health policy, the research team aimed to estimate how much tackling these changeable factors in the lives of people with severe mental illness could translate into a gain in life expectancy.

Using data from systematic reviews, the research team investigated the links between a range of different risk factors and the total number of deaths among participants with severe mental illness.

The factors were categorized into three groups: behavioral risk factors, such as smoking and physical inactivity; healthcare risk factors, such as uptake of treatment and access to healthcare resources; and social risk factors, such as stigma and exclusion.

By considering the effectiveness of interventions aimed at changing these factors, the research team then calculated the gains in life expectancy that could occur. Examples of interventions to address the risk factors were smoking cessation initiatives, improving access to antipsychotic medication and educational approaches to help reduce mental health stigma.

The analysis findings suggest that approaches that tackle all of these factors could produce a potential gain in life expectancy of four years for those with bipolar disorder and seven years for those with schizophrenia. Gains in life expectancies were also estimated later in life and at 65 years the projected gain was three years for bipolar disorder and four years for schizophrenia.

“Our study shows that by addressing the health behaviors, health care engagement and social issues of people with severe mental illness we could potentially increase their life expectancy by about 4 to 7 years,” said lead author Dr. Alex Dregan from the Institute of Psychiatry, Psychology & Psychiatry at King’s College London.

“The analysis indicates that, when considering different approaches to help those with severe mental illness, the whole is greater than the sum of the parts and there is more benefit if a multifaceted approach is taken which addresses behaviour, healthcare and social issues simultaneously.”

“Greater investments in developing more effective interventions aimed at reducing unhealthy behaviors and treating the underlying symptoms would contribute to reducing the gap in premature mortality between those with severe mental illness and the general population.”

The study is published in the journal PLOS ONE.

Source: King’s College London

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