Everyone knows about the incredible health risks associated with lighting up and drawing nicotine and other toxic chemicals into their lungs and bloodstreams, but the oft-deadlier consequences of a number of other addictions and mental illnesses can frequently be clouded by the public's intense focus on tobacco smoke.
Citing the World Health Organization's Global Burden of Disease study, University of Oxford psychiatrists say mental and behavioral disorders accounted for 232,000 deaths in 2010—up from 138,000 in 1990. More than three-quarters of those 2010 deaths were linked to substance abuse disorders. Some of the disorders have stronger associations with premature deaths than smoking.
"Smoking has been an important target for preventions because it is so common and perceived to be so dangerous. Mental disorders are also relatively common when considered together, but the risk to life is not perceived in the same way."
"Smoking has been an important target for preventions because it is so common and perceived to be so dangerous," the psychiatrists write in a research report published recently in World Psychiatry. "Mental disorders are also relatively common when considered together, but the risk to life is not perceived in the same way."
The researchers pored over dozens of systematic reviews and meta-analyses dealing with life expectancy and deaths associated with various mental illnesses and addictions. They used the data from these papers to estimate mortality risks, which they compared with the risks of heavy smoking.
The results were as jarring as a blaring smoke alarm.
"From a public health perspective, patients with serious mental illness should be designated as a high risk population for physical illness, given the substantial health disparities compared with the general population," they write.
Here were the mental illnesses and addictions with especially high mortality risks when compared with the dangers of heavy smoking (which already more than doubles somebody's risk of dying young):
- Post-partum psychiatric admission: 770 percent greater association with premature death than heavy smoking
- Opioid use: 580 percent
- Amphetamine use: 240 percent
- Cocaine use: 240 percent
- Anorexia nervosa: 230 percent
- Methamphetamine use: 180 percent
- Psychotic disorders: 180 percent
- Alcoholism: 180 percent
- Personality disorder: 170 percent
- Moderate to profound intellectual disability: 110 percent
- Heavy smoking: 100 percent
- Schizophrenia: 100 percent
- Bipolar disorder: 80 percent
- Bulimia nervosa: 80 percent
- Other eating disorders: 80 percent
- Adults who were diagnosed with ADHD as children: 80 percent
- Depression: 60 percent
- Depression and anxiety: 60 percent
- Cannabis use: 50 percent
Simply grasping these elevated risks doesn't tell the researchers why sufferers of these ailments and addictions are so prone to earlier deaths.
"We do not know the precise reasons for the excess mortality risk, and more research understanding mediators of this increased risk is necessary," says Seena Fazel, one of the authors of the paper. "A key determinant of this increased mortality is suicide—and these are often caused by the symptoms of the underlying mental disorder."