The epidemiology of excess mortality in people with mental illness

Objective: To investigate the burden of excess mortality among people with mental illness in developed countries, how it is distributed, and whether it has changed over time. Method: We conducted a systematic search of MEDLINE, restricting our attention to peer-reviewed studies and reviews published in English relating to mortality and mental illness. Because of the large number of studies that have been undertaken during the last 30 years, we have selected a representative cross-section of studies for inclusion in our review. Results: There is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death. Consistently elevated rates have been observed across settings and over time. The highest numbers of excess deaths are due to cardiovascular and respiratory diseases. With life expectancy increasing in the general population, the disparity in mortality outcomes for people with mental illness is increasing. Conclusions: Without the development of alternative approaches to promoting and treating the physical health of people with mental illness, it is possible that the disparity in mortality outcomes will persist

Cancer risk among users of neuroleptic medication: a population-based cohort study

It has been suggested that neuroleptic medication may decrease cancer risk. We compared cancer risks in a population-based cohort study of 25 264 users (⩾2 prescriptions) of neuroleptic medications in the county of North Jutland, Denmark, during 1989–2002, with that of county residents who did not receive such prescriptions. Statistical analyses were based on age-standardisation and Poisson regression analysis, adjusting for age, calendar period, COPD, liver cirrhosis or alcoholism, use of NSAID, and, for breast cancer, additionally for use of hormone therapy, age at first birth, and number of children. Use of neuroleptic medications was associated with a decreased risk for rectal cancer in both women and men (adjusted IRRs of 0.61 (95% confidence interval, 0.41–0.91) and 0.82 (0.56–1.19), respectively) and for colon cancer in female users (0.78; 0.62–0.98). Some risk reduction was seen for prostate cancer (0.87; 0.69–1.08), but breast cancer risk was close to unity (0.93; 0.74–1.17). Overall, treatment with neuroleptic medications was not related to a reduced risk of cancer, but for cancers of the rectum, colon and prostate there were suggestive decreases in risk

Editorial: The prevention of suicide : Controlling the environment

Antoon A. Leenaars, Diego de Leo, Robert D. Goldney, Walter H. Gulbinat and M. David Wallace

Statistics and Information Systems

The World Health Organization (WHO) defines a Mental Health Information System (MHIS) as a \u201csystem for collecting, processing, analyzing, disseminating and using information about a mental health service and the mental health needs of the population it serves\u201d (WHO, 2005). A system is seen as \u201ca collection of components that work together to achieve a common objective\u201d (WHO Regional Office for the Western Pacific, 2004). The objective of a MHIS is to serve as a tool for improving the mental health of a population and its individual members. The question to be discussed is in which way issues of classification and diagnosis may contribute to this objective. Before this can be done the main uses of MHISs will be identified, the information and data typically processed in such a system will be reviewed, and, thirdly, the role of a common language will be analyzed aimed at facilitating communication and understanding among the users of such systems

Exemple de programme pour la promotion de la santé mentale et neurologique au travail en équateur.

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