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Poor mental health may up chance for early death

January 27, 2021  By University of Michigan

Poor early-life mental health may jeopardize later-life physical health, according to a new study.

The study in the journal JAMA Network Open indicates that people who experience psychiatric conditions when they are young are likely to experience excess age-related physical diseases when they are older.

Leah Richmond-Rakerd, an assistant professor of psychology at the University of Michigan, and colleagues found that preexisting physical illness cannot explain this association.

The researchers ruled out the possibility of reverse causation in which having a physical illness precipitates mental health problems. Prior studies had not taken this into account. This association is present across different mental disorders and different physical diseases, Richmond-Rakerd says.


The researchers conducted a nationwide hospital-register study of 2.3 million New Zealanders—aged 10-60 years at baseline—followed across three decades (1988 to 2018). They tested whether individuals with mental disorders are at increased risk for subsequent chronic physical diseases and premature mortality.

The researchers collected information about hospital admissions for different mental disorders, such as substance use disorders, psychotic disorders, mood disorders, anxiety disorders, and self-harm behavior. In addition, researchers collected information about hospital admissions for different chronic physical diseases, ranging from coronary heart disease to cancer.

Across the 30-year period, individuals with mental disorders were more likely to develop subsequent physical diseases and they also died earlier than people without mental disorders, the study shows. They also experienced more medical hospitalizations, spent more time in hospitals for physical-disease treatment, and accumulated more associated health care costs. These associations were present across all age groups and in both men and women.

The findings indicate that addressing mental health problems in early life might be a window of opportunity for preventing future physical diseases, Richmond-Rakerd says. They also suggest the importance of joined-up services, or integrated care.

“Our health care system often divides treatment between the brain and the body,” she says. “Integrating the two could benefit population health.”

Richmond-Rakerd says they chose New Zealand because there it is possible to link hospital registers and other administrative databases for the entire population of the country.

Additional coauthors are from the University of Auckland, Duke University, and King’s College London.

Support for the research came from the National Institute on Aging, the UK Medical Research Council, the National Institute of Child Health and Development, and the Jacobs Foundation.