A systematic review and meta-analysis by British scientists found that people with bipolar disorder, schizophrenia, or schizoaffective disorder have a nearly threefold increased risk of death from infections compared to the general population. As reported in the journal eClinicalMedicine, the highest risk of death is observed for respiratory infections.
It is known that people with severe mental illnesses die 10 to 20 years earlier than the healthy population. Approximately nine percent of this premature mortality is due to unnatural causes—suicide and self-harm. However, psychiatrists observe that life expectancy in such patients is significantly reduced due to physical health factors.
Several reviews have shown that psychiatric patients have an increased risk of death from cardiovascular, respiratory, and oncological diseases. A small number of studies have also demonstrated that this patient cohort is at increased risk of death from infectious diseases. However, early systematic studies of this relationship were limited in the infections and psychiatric conditions examined.
Therefore, a research team led by Amy Ronaldson of King's College London conducted a systematic review and meta-analysis of studies on the risk of mortality from infectious diseases in people with serious mental disorders. A total of 29 studies were included in the analysis.
The primary analysis showed that a diagnosis of serious psychiatric illness—bipolar disorder, schizophrenia, schizoaffective disorder, and other psychoses—was associated with an increased risk of death from infectious diseases. The overall relative risk of death from infection among psychiatric patients was more than twice that of the general population or healthy control groups (overall relative risk 2.71). Men were at higher risk than women.
An analysis of specific infections showed that the risk of death from respiratory tract infections in patients with severe mental disorders increased by 3.27 times. The highest statistical significance was observed for pneumonia. Notably, the risk of death from sepsis was virtually unchanged between psychiatric patients and healthy control groups. Furthermore, the risk of death from other infections also did not differ significantly between control groups; the lowest risk of death from infection was observed in schizophrenia.
According to the authors, this study highlights the importance of monitoring the physical health of psychiatric patients. It may be necessary to develop specialized infectious disease prevention measures that are effective specifically for this patient cohort.
We previously reported that people with psychosis are more likely to have DNA from the Bartonella bacteria in their blood than people without a history of psychosis.
