A systematic review and meta-analysis by British scientists showed that people with bipolar disorder, schizophrenia or schizoaffective disorder have a nearly three-fold increased risk of dying from infections compared to the general population. As reported in the journal eClinicalMedicine, the highest risk of death is observed with respiratory infections.
It is known that people with severe mental illness die 10 to 20 years earlier than the healthy population. About nine percent of this premature mortality is due to unnatural causes - suicide and self-harm. However, psychiatrists observe that the life expectancy of such patients is significantly reduced due to physical health factors.
For example, several reviews have shown that psychiatric patients have an increased risk of dying from cardiovascular, respiratory, and cancer diseases. A small number of studies have also shown that this patient cohort is at increased risk of dying from infectious diseases. However, early systematic studies of this relationship were limited in the infections and psychiatric conditions studied.
So a research team led by Amy Ronaldson of King's College London conducted a systematic review and meta-analysis of studies looking at the risk of infectious disease mortality in people with serious mental disorders. The analysis included 29 studies.
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 pooled relative risk of death from infection among psychiatric patients was more than twice that of the general population or healthy controls (pooled relative risk 2.71). Men were at greater risk than women.
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. Moreover, the highest statistical significance was observed for pneumonia. Notably, the risk of death from sepsis was almost identical between psychiatric patients and healthy control groups. In addition, the risk of death from other infections was also not significantly different from control groups; also, the lowest risk of death from infection was observed in schizophrenia.
According to the authors of the work, this study reflects the importance of monitoring the somatic health of psychiatric patients. It may be necessary to develop specialized measures for the prevention of infectious diseases that would be effective in this particular cohort of patients.
We previously reported that people with psychosis are more likely to have DNA of the Bartonella bacteria in their blood than people without a history of psychosis.