ArticleJournal of affective disorders2023
Life years lost associated with mental illness: A cohort study of beneficiaries of a South African medical insurance scheme.
Article in Journal of affective disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 10 citations in OpenAlex.
- Risk of all-cause and cause-specific mortality, and suicide attempt in people with anxiety and stress-related disorders: a systematic review, meta-analysis and meta-regression analysis of 165 studies.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Demographic Factors and Trends Associated with Mortality After AIDS Diagnosis in Puerto Rico.Infectious disease reports · 2026Article
- Life-years lost associated with mental disorders in people with HIV: a cohort study in South Africa, Canada and the United States.Journal of the International AIDS Society · 2025Article
- Lived Challenges Contributing to Mental Illness Relapse and Coping Strategies Used by Teachers in Limpopo Province.International journal of environmental research and public health · 2025Article
- Does life expectancy vary by disability status in LMICs?: A systematic review and meta-analysis.African journal of disability · 2025Review
- Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme.Epidemiology and psychiatric sciences · 2024Article
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14 authors at 4 institutions in 4 countries.
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Abstract
backgroundPeople with mental illness have a reduced life expectancy, but the extent of the mortality gap and the contribution of natural and unnatural causes to excess mortality among people with mental illness in South Africa are unknown.
methodsWe analysed reimbursement claims from South African medical insurance scheme beneficiaries aged 15-85 years. We estimated excess life years lost (LYL) associated with organic, substance use, psychotic, mood, anxiety, eating, personality, developmental or any mental disorders.
resultsWe followed 1,070,183 beneficiaries for a median of three years, of whom 282,926 (26.4 %) received mental health diagnoses. Men with a mental health diagnosis lost 3.83 life years (95 % CI 3.58-4.10) compared to men without. Women with a mental health diagnosis lost 2.19 life years (1.97-2.41) compared to women without. Excess mortality varied by sex and diagnosis, from 11.50 LYL (95 % CI 9.79-13.07) among men with alcohol use disorder to 0.87 LYL (0.40-1.43) among women with generalised anxiety disorder. Most LYL were attributable to natural causes (men: 3.42, women: 1.94). A considerable number of LYL were attributable to unnatural causes among men with bipolar (1.52) or substance use (2.45) disorder. LIMITATIONS: Mental diagnoses are based on reimbursement claims.
conclusionsPremature mortality among South African individuals with mental disorders is high. Our findings support interventions for the prevention, early detection, and treatment of physical comorbidities in this population. Targeted programs for suicide prevention and substance use treatment, particularly among men, can help reduce excess mortality from unnatural causes.
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