SMI Mortality Gap — MRCPsych Paper B MCQ

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EasySchizophrenia & PsychosisSMI Mortality GapMRCPsych Paper B

During a physical health review, a 45-year-old man with chronic schizophrenia asks about the mortality gap associated with severe mental illness. Compared with the general population, by approximately how much is life expectancy reduced among adults with severe mental illness such as schizophrenia?

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Correct answer: B — 15–20 years

The correct answer is B. Current UK sources estimate that adults with severe mental illness, including schizophrenia and bipolar disorder, have a life expectancy approximately 15–20 years shorter than the general population. Much of the excess mortality is associated with preventable or treatable physical illness, particularly cardiovascular, respiratory and metabolic disease, although suicide also contributes. Relevant factors include smoking, socioeconomic disadvantage, barriers to healthcare, physical inactivity and the metabolic adverse effects of some antipsychotics. Reductions of 1–2 or 5–7 years substantially underestimate the recognised gap, whereas 30–40 years is excessive as a population estimate. There is a clear mortality difference, so option E is incorrect.

Reference: Royal College of Psychiatrists, “87,000 people with a severe mental illness have died from preventable physical health conditions in three years,” 2024. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2024/10/10/87-000-people-with-a-severe-mental-illness-have-died-from-preventable-physical-health-conditions-in-three-years