امید به زندگی در بدو تولد و مرگ و میر در میان افراد مبتلا به اختلال شخصیت

Objective It is well established that serious mental illness is associated with raised mortality, yet few studies have looked at the life expectancy of people with personality disorder (PD). This study aims to examine the life expectancy and relative mortality in people with PD within secondary mental health care. Methods We set out to examine this using a large psychiatric case register in southeast London, UK. Mortality was obtained through national mortality tracing procedures. In a cohort of patients with a primary diagnosis of PD (n = 1836), standardised mortality ratios (SMRs) and life expectancies at birth were calculated, using general population mortality statistics as the comparator. Results Life expectancy at birth was 63.3 years for women and 59.1 years for men with PD—18.7 years and 17.7 years shorter than females and males respectively in the general population in England and Wales. The SMR was 4.2 (95% CI: 3.03–5.64) overall; 5.0 (95% CI: 3.15–7.45) for females and 3.5 (95% CI: 2.17–5.47) for males. The highest SMRs were found in the younger age groups for both genders. Conclusion People with PD using mental health services have a substantially reduced life expectancy, highlighting the significant public health burden of the disorder.

Mental disorder is an established risk factor for increased mortality [1] and [2]. People with mental disorders die prematurely for a variety of reasons, including poor physical health [3], [4] and [5], adverse physiological consequences of long term psychotropic medication, unhealthy lifestyle [5], as well as increased death rates as a result of suicide, accidents and homicide [6], [7] and [8]. The risk of increased mortality has been shown to vary according to type of mental disorder, with substance use disorders conferring a particularly high risk of early death [1], [9] and [10]. Personality disorder is a global health problem [11]. It is one of the hardest psychiatric conditions to treat and has a considerable economic impact on general medical and mental health services. People with personality disorder (PD) are known to be at particularly high risk of increased mortality as a result of both natural and unnatural causes [12], [13], [14], [15] and [16]. However, no study has comprehensively examined life expectancy at birth of the full range of secondary care service users with PD. Life expectancy is a vital public health statistic which serves as a readily identifiable indicator of general mortality in a specified population followed up for a certain period of time.