Physical health challenges faced by elders with severe mental illness: population-based retrospective cohort study
Journal
BJPsych Open
Journal Volume
10
Journal Issue
6
Start Page
e178
ISSN
2056-4724
Date Issued
2024-10-15
Author(s)
Hayes, Richard D.
Broadbent, Matthew
Shetty, Hitesh
Su, Yu-Ping
Meesters, Paul D.
Stewart, Robert
Abstract
Background
Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly.
Aims
To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI.
Method
To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission.
Results
In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00–I99) to 6.99 for genitourinary system or urinary conditions (N00–N39). Specifically, the diagnostic group of ‘symptoms, signs and findings, not elsewhere classified’ (R00–R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00–K93), after adjusting for confounding.
Conclusions
Poorer overall physical health and specific patterns were identified in elders with SMI.
Subjects
Severe mental illness
bipolar disorder
hospital admission
schizoaffective disorder
schizophrenia
SDGs
Publisher
Royal College of Psychiatrists
Type
journal article