NIMH: Death Rate Higher with First Episode of Psychosis in Young People

Young people who are newly diagnosed with psychosis have a much higher mortality rate than people of the same age in the general population, according to National Institute of Mental Health (NIMH) researchers.

Their National Institutes of Health (NIH)-funded study examined commercial insurance data on 5,000 young-adult patients—aged 16 to 30 years—with psychosis, and followed the cohort for 12 months from the time of each individual’s initial diagnosis. The data revealed that, overall, this population had a 24 times greater mortality rate from any cause of death than individuals similarly aged. The NIMH researchers pointed out that in the United States, the only other population group with a mortality rate resembling that of the study group is the elderly over the age of 70.

In a joint release from the NIMH and NIH, Michael Schoenbaum, PhD (photo), the lead author on the study—published online by Schizophrenia Bulletin—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.”.

He also stressed the importance of future research, adding, “Of course, we also need to learn how these young people are losing their lives.”

Using insurance claims data as well as data from the Social Security Administration, the team was able to identify how many deaths occurred in the study population, although data on the causes or manner of death were not available and, therefore, not studied.

The researchers also looked at data on the medical and psychosocial care that patients with psychosis received in the first 12 months following their diagnosis. Those findings showed low rates of medical oversight, with 61% of patients not receiving antipsychotic medications, and 41% not receiving psychotherapy. The patients who died within the critical first year of their diagnosis relied heavily on hospital and emergency care.

“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,” said Robert Heinssen, PhD, a co-author of the paper, in the press release.

With this research, the NIMH team expressed the continuing need for federal and state agencies to fund evidence-based psychosis treatment programs, as well as the need for local communities to invest in treatment programs.

“The future of this research will show us what is happening with young people in this population, and help us tailor interventions to address their risks,” Schoenbaum said. “In the meantime, this study is a wake-up call telling us that young people experiencing psychosis need intensive, integrated clinical and psychosocial supports.”

The study, “Twelve-Month Health Care Use and Mortality in Commercially Insured Young People with Incident Psychosis in the United States,” is in press with Schizophrenia Bulletin.

The findings were announced in a news release.

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