Mortality and Suicide

People with severe mental disorders such as schizophrenia and bipolar affective disorder die 15-20 years earlier than the general population. Four general factors help explain this unacceptably high mortality rate among mentally ill patients: Suboptimal health-related behaviour, adverse effects of medicine, increased risk of suicide and high levels of somatic/mental comorbidities, including insufficient treatment.

It is a well-known fact that persons with severe mental disorders have an excess mortality as a result of accidents or suicide. However, the main explanation for early death in patients suffering from severe mental disorders is that they are more often affected by physical illness, for which they are treated poorly or too late compared to the general population. Actually, in many cases, physical illness is not discovered at all, and may be side effects of medicine. Moreover, persons with severe mental disorders also have a lifestyle characterised by lack of exercise, and therefore have a higher risk of complications from obesity.

Access to various Danish Registers makes it possible for researchers at NCRR to follow up on decades of data in order to examine the high excess mortality and to suggest causes, with the possibility to reduce them. As an example, researchers at NCRR have contributed to studies showing that persons with mental disorders are less likely to be treated for heart disease and use less medication for cardiovascular diseases, even though they are more vulnerable compared to the general population.

Recently, NCRR has extended its research to large-scale population-based genetic studies as well as studies of gene-environment interactions (GxE interaction). This has created new opportunities to take both genes and environment into consideration when studying the excess mortality in people with mental disorders.

Moreover, NCRR recently entered into collaboration with Professor John McGrath from the University of Queensland in a Niels Bohr professorship, which, among other interesting projects, will involve NCRR in the Global Burden of Disease project and the WHO World Mental Health Survey Initiative - examining the treatment of mental disorders worldwide.

Currently, NCRR is involved in projects that examine research questions like:

  • How do genes affect the high mortality rate among people with schizophrenia?
  • Do genes that increase risk of schizophrenia also increase risk of early death?
  • How does air-pollution affect mortality?
  • How does the presence of multiple mental illnesses affect mortality?
  • What causes of death may explain the excess mortality among mentally ill patients (Percentage of mortality caused by suicide, cardiovascular disease, cancer, etc.)?

For further reading:

Erlangsen., et al. (2017) “Cause-specific life-years lost in people with mental disorders: a nationwide, register-based cohort study.” Lancet Psychiatry:

Laursen, T., et al. (2017) Mortality and Self-Harm in Association with Clozapine in Treatment-Resistant Schizophrenia.” The American Journal of Psychiatry:

Liu, Nancy H., et al (2017) Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry:10.1002/wps.20384

Laursen, T., et al. (2016). ”Association of the polygenic risk score for schizophrenia with mortality and suicidal behaviour – a Danish population-based study”. Schizophrenia Research:

Ribe, Anette Rissgaard., et al (2016) Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness : A Danish Population-Based Cohort Study.  PloS one:

Laursen, T. M., et al (2016) Mortality and life expectancy in persons with severe unipolar depression. Journal of Affective Disorders: 10.1016/j.jad.2015.12.067

Dalsgaard, S., et al (2015). “Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study”. The Lancet:

Laursen, T., et al (2014). “Excess early Mortality in Schizophrenia”. Annual Review of Clinical Psychology:

Nordentoft, M., et al. (2011). "Absolute risk of suicide after first hospital contact in mental disorder." Arch Gen Psychiatry: 10.1001/archgenpsychiatry.2011.113

Laursen, T., et al. (2011). “Life expectancy among persons with schizophrenia or bipolar affective disorders”. Schizophrenia Research: