Tuesday, September 18, 2012

Why Psychiatric Patients Die Younger

If you're reading this for the answer, you can stop now.  I don't know why psychiatric patients die younger than people who do not have psychiatric disorders.  I think that fact only applies to those with chronic psychiatric illnesses, not to someone who has had a single episode of depression or anxiety.  What qualifies as a chronic mental illness?  I'm not sure -- but certainly if you get on-going disability (SSDI) benefits because of your psychiatric disorder, or if you live with a careprovider and attend a long-term psychosocial rehabilitation program for years, or have resided in a state hospital for years.  

How much less time do psychiatric patients live?  The numbers vary from 8 years to 25 years, though I have hard time believing that the average lifespan of a psychiatric patient is only a little over 50.  I have had a few psychiatric patients who have died young, but none under age 50.

So, if we start from the premise that psychiatric patients die younger than people without chronic and persistent mental illnesses, then why?  I'll throw out some ideas.  None of them are the right answer because there is no right answer, just my thoughts on some possible contributing factors.

  • Poor coordination of care: psychiatric patients may be less likely to make appointments, coordinate their care, and may receive medical treatment of their conditions at a substandard rate. (Roy likes this one, I bet)
  • Psychiatric patients smoke cigarettes at rates that are higher than the general public.   
  • Psychiatric medications predispose people to weight gain and metabolic syndromes that may precipitate diabetes and heart disease.
  • Psychiatric patients have high co-morbidity with substance abuse disorders and substance abusers die young for many reasons.
  • Psychiatric patients have higher rates of suicide and suicide is common cause of death among young people.
  • People with psychiatric disorders may not be evaluated as carefully as people without such disorders when they present to a medical professional with problems.  The medical professionals may be too quick to attribute problems to anxiety or depression or psychiatric concerns.
  • Certain psychiatric conditions may predispose people to  behaviors that are not good for them.
  • Certain psychiatric conditions may predispose people to have less interest in investing energy in the caring for themselves or making lifestyle decisions that favor good health.
  • Chronic mental illness is associated with poverty and this is associated with obesity, and as well as a lower likelihood of investing in more expensive and healthier food choices, gym memberships, and a full range of medical care.
  • Patients with psychiatric disorders may have fewer close relationships and family members often cajole their relatives to take care of themselves, pursue medical care, and provide a reason to live.
Just my thoughts.  Tell me what I missed.