Young people having a first psychosis episode show a much higher death rate than previously thought, a new study suggests. Data came from around 5,000 individuals aged 16-30 with commercial health insurance who had received a new psychosis diagnosis, and were followed for the next 12 months.
Researchers found that the group had a mortality rate at least 24 times greater than the same age group in the general population, in the 12 months after the initial psychosis diagnosis. The study, funded by the National Institute of Mental Health (NIMH), highlights that young people experiencing psychosis warrant intensive and proactive treatments, services and supports.
They used data from the Social Security Administration to identify deaths in this population within 12 months of the initial psychosis diagnosis. Data on cause or manner of death were not available for this research. In the general US population, only individuals over age 70 come close to a similar 12-month mortality rate.
Mortality Rate Tracking Important
Michael Schoenbaum, Ph.D., senior advisor for Mental Health Services, Epidemiology, and Economics at NIMH, who led the study, said:
“These findings show the importance of tracking mortality in individuals with mental illness. Health systems do this in other areas of medicine, such as cancer and cardiology, but not for mental illness. Of course, we also need to learn how these young people are losing their lives."
The study also examined the health care individuals received in the 12 months after the initial psychosis diagnosis. Those data showed that young people with a new psychosis diagnosis had surprisingly low rates of medical oversight and only modest involvement with psychosocial treatment providers.
Overall, 61 percent of them did not receive any antipsychotic medications, and 41 percent did not receive any psychotherapy. Those who died within 12 months of diagnosis received even less outpatient treatment and relied more heavily on hospital and emergency care.
Co-author Robert Heinssen, Ph.D., director of the Division of Intervention Services at NIMH, said:
“Other studies have shown that early coordinated treatment for psychosis produces the best results. However, we know that the typical duration of untreated psychosis in the United States is around 17 months. This study reinforces federal and state support for funding evidence-based psychosis treatment programs across the country, and the need for communities to invest in more treatment programs."
Michael Schoenbaum Jason M. Sutherland Andre Chappel Susan Azrin Amy B. Goldstein Agnes Rupp Robert K. Heinssen Twelve-Month Health Care Use and Mortality in Commercially Insured Young People With Incident Psychosis in the United States Schizophr Bull sbx009. DOI: https://doi.org/10.1093/schbul/sbx009