Severe Mental Illness and Type 2 Diabetes Outcomes and Complications: A Nationwide Cohort Study
Authors' conclusion
Among people with diabetes, people with a history of SMI have poorer cardiovascular and mortality outcomes compared with those without mental illness. While the underlying mechanisms are further investigated, effective prevention and management of cardiovascular risk factors is needed in this high-risk group.
Study context
- Population
- Adults diagnosed with T2D 2004–2018, national Scottish diabetes register; mental illness history from linked psychiatric and general hospital admission records
- Participants
- 259,875 adults
- Exposure
- Severe mental illness (SMI) vs no mental illness
- Outcome
- Major CVD events, all-cause mortality and CVD-specific mortality
Methodological detailsrecord linkage, Cox regression
- Record linkage
- Cox regression
Main finding
As reported in the abstract
Major CVD events
Each group vs no mental illnessHazard ratio (95% CI)
Schizophrenia
1.22(1.06–1.41)
Bipolar disorder
1.58(1.33–1.87)
Major depression
1.59(1.49–1.70)
Observational data: associations, not effects.
Further findings
| Outcome | Schizophrenia | Bipolar disorder | Major depression |
|---|---|---|---|
| Prevalence of SMI | 1.0% | 0.5% | 3.0% |
Cardiovascular disease (CVD)-specific and all-cause mortality
- SMI associated with an approximately twofold increased risk of CVD-specific and all-cause mortality
- All associations attenuated after further adjustment for clinical characteristics
Original publication
Severe Mental Illness and Type 2 Diabetes Outcomes and Complications: A Nationwide Cohort Study. Diabetes Care. Published 2 May 2023. doi:10.
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