Journal
LANCET REGIONAL HEALTH-EUROPE
Volume 11, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.lanepe.2021.100228
Keywords
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Funding
- ESRC Centre for Society and Mental Health at King's College London (ESRC) [ES/S012567/1]
- ESRC [ES/S002715/1]
- Health Foundation
- Academy of Medical Sciences
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
- King's College London
- National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust
- ESRC [ES/S002715/1] Funding Source: UKRI
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The study reveals the impact of COVID-19 on mortality rates of individuals with mental disorders and intellectual disabilities, showing that during the COVID-19 pandemic, the mortality rates of these patients further increased, with significant differences in SMRs among different psychiatric conditions, while similar risks were observed across ethnic groups.
BACKGROUND: People with mental disorders and intellectual disabilities experience excess mortality compared with the general population. The impact of COVID-19 on exacerbating this, and in widening ethnic inequalities, is unclear. METHODS: Prospective data (N=167,122) from a large mental healthcare provider in London, UK, with deaths from 2019 to 2020, used to assess age- and gender-standardised mortality ratios (SMRs) across nine psychiatric conditions (schizophrenia-spectrum disorders, affective disorders, somatoform/ neurotic disorders, personality disorders, learning disabilities, eating disorders, substance use disorders, pervasive developmental disorders, dementia) and by ethnicity. FINDINGS: Prior to the World Health Organization (WHO) declaring COVID-19 a public health emergency on 30th January 2020, all-cause SMRs across all psychiatric cohorts were more than double the general population. By the second quarter of 2020, when the UK experienced substantial peaks in COVID-19 deaths, all-cause SMRs increased further, with COVID-19 SMRs elevated across all conditions (notably: learning disabilities: SMR: 9.24 (95% CI: 5.98-13.64), pervasive developmental disorders: 5.01 (95% CI: 2.40-9.20), eating disorders: 4.81 (95% CI: 1.56-11.22), schizophrenia-spectrum disorders: 3.26 (95% CI: 2.55-4.10), dementia: 3.82 (95% CI: 3.42, 4.25) personality disorders 4.58 (95% CI: 3.09-6.53)). Deaths from other causes remained at least double the population average over the whole year. Increased SMRs were similar across ethnic groups. INTERPRETATION: People with mental disorders and intellectual disabilities were at a greater risk of deaths relative to the general population before, during and after the first peak of COVID-19 deaths, with similar risks by ethnicity. Mortality from non-COVID-19/ other causes was elevated before/ during the pandemic, with higher COVID-19 mortality during the pandemic. (C) 2021 The Authors. Published by Elsevier Ltd.
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