Nejvíce citovaný článek - PubMed ID 36335974
Mortality and life-years lost following subsequent physical comorbidity in people with pre-existing substance use disorders: a national registry-based retrospective cohort study of hospitalised individuals in Czechia
INTRODUCTION: The aim was to analyse mortality and estimate the life expectancy among people hospitalised for alcohol use disorders (AUD) compared with the general Czech population aged ≥20 years. A temporal perspective on excess mortality was used, covering three recent calendar periods before and during the pandemic. METHODS: Three retrospective cohorts of the target population were constructed using registry-based data. The target population was defined as all adult patients (aged ≥20 years) admitted to the hospital for AUD (ICD-10 dg. of F10.x) between 2010 and 2021. Age-adjusted mortality rates and life expectancies were calculated for the comparative analysis. Official Czech mortality and vital statistics were used for the comparison. A Poisson log-linear regression model was used to test the effect of the pandemic period (2020-2021) on mortality in the AUD target population. RESULTS: At age 20, the estimated life expectancy of the AUD target was 21-27 years less than that of the Czech general population. Excess mortality was relatively highest in young people aged 20-34 years and in adults aged 35-49 years. During the pandemic period 2020-2021, mortality rates in the target AUD increased significantly. However, relative inequalities with the general Czech population did not change significantly. DISCUSSION AND CONCLUSIONS: People hospitalised for AUD have much higher mortality rates, resulting in markedly reduced life expectancy. During the pandemic, their mortality rates increased even more. However, the increase was no greater than in the general Czech population.
- Klíčová slova
- COVID pandemic, alcohol use disorders, life expectancy, mortality,
- MeSH
- alkoholismus * mortalita MeSH
- COVID-19 * epidemiologie MeSH
- dospělí MeSH
- hospitalizace * trendy statistika a číselné údaje MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- naděje dožití * trendy MeSH
- pandemie * MeSH
- poruchy způsobené alkoholem * mortalita MeSH
- registrace MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are autoimmune illnesses characterised by chronic inflammation demonstrating differential associations with psychiatric conditions. OBJECTIVE: In this matched-cohort study, we aimed to investigate whether the associations between these inflammatory illnesses and mental disorders are predominantly the consequence of the burden of the former or whether common causes might underpin the susceptibility to both. METHODS: Using Czech national inpatient care data, we identified individuals with RA or axSpA during the years 1999-2012. We investigated the occurrence of psychiatric outcomes up to 2017 using stratified Cox proportional hazards models. In evidence triangulation, we assessed the potential moderation by age at inflammatory illness, the associations relative to counterparts with other similarly burdensome chronic illnesses and the temporal ordering of conditions. FINDINGS: Both RA and axSpA were associated with mood and anxiety disorders and behavioural syndromes. In evidence triangulation, the associations with depression showed a decreasing age-at-inflammatory-illness gradient in RA; the association between RA and depression was stronger than that between other chronic illnesses and depression; and excluding prevalent depression attenuated the RA-depression association. RA showed consistent inverse associations with schizophrenia and Alzheimer's disease. CONCLUSIONS: Common aetiologies might be involved in increasing the risk of developing both RA and depression. The consistent inverse associations between RA and schizophrenia and between RA and Alzheimer's disease suggest that at least part of these associations might also be a consequence of shared aetiologies as well as potential medication effects. CLINICAL IMPLICATIONS: People with autoimmune arthritides are more likely to experience mood and anxiety disorders, even relative to counterparts with other similarly burdensome chronic illnesses.
- Klíčová slova
- Adult psychiatry, Depression, Schizophrenia & psychotic disorders,
- MeSH
- dospělí MeSH
- duševní poruchy * epidemiologie MeSH
- kohortové studie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- revmatoidní artritida * epidemiologie MeSH
- senioři MeSH
- spondylartritida * epidemiologie MeSH
- zánět * epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: It remains unknown whether severe mental disorders contribute to fatally harmful effects of physical illness. AIMS: To investigate the risk of all-cause death and loss of life-years following the onset of a wide range of physical health conditions in people with severe mental disorders compared with matched counterparts who had only these physical health conditions, and to assess whether these associations can be fully explained by this patient group having more clinically recorded physical illness. METHOD: Using Czech national in-patient register data, we identified individuals with 28 physical health conditions recorded between 1999 and 2017, separately for each condition. In these people, we identified individuals who had severe mental disorders recorded before the physical health condition and exactly matched them with up to five counterparts who had no recorded prior severe mental disorders. We estimated the risk of all-cause death and lost life-years following each of the physical health conditions in people with pre-existing severe mental disorders compared with matched counterparts without severe mental disorders. RESULTS: People with severe mental disorders had an elevated risk of all-cause death following the onset of 7 out of 9 broadly defined and 14 out of 19 specific physical health conditions. People with severe mental disorders lost additional life-years following the onset of 8 out 9 broadly defined and 13 out of 19 specific physical health conditions. The vast majority of results remained robust after considering the potentially confounding role of somatic multimorbidity and other clinical and sociodemographic factors. CONCLUSIONS: A wide range of physical illnesses are more likely to result in all-cause death in people with pre-existing severe mental disorders. This premature mortality cannot be fully explained by having more clinically recorded physical illness, suggesting that physical disorders are more likely to be fatally harmful in this patient group.
- Klíčová slova
- Psychotic disorders/schizophrenia, bipolar type I or II disorders, comorbidity, depressive disorders, mortality and morbidity,
- MeSH
- dospělí MeSH
- duševní poruchy * epidemiologie MeSH
- kohortové studie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- příčina smrti * MeSH
- registrace statistika a číselné údaje MeSH
- senioři MeSH
- zdravotní stav MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH