Excess mortality after mental disorder diagnosis within and outside specialist psychiatric care: nationwide cohort study

Excess mortality after mental disorder diagnosis in Finland is overall elevated (adjusted MRR 2.65, 95% CI 2.53–2.77) across 63 million person-years, but varies sharply by subgroup.

• Why it matters: Most excess-mortality evidence comes from specialist psychiatric populations, leaving uncertainty about how risk changes across the broader diagnosed population by care context and time since diagnosis.
• What they did: In a nationwide cohort of 5,526,599 residents aged 5–95 followed from 2011–2023, investigators estimated mortality rate ratios by ICD-11 diagnosis group, time since diagnosis, psychiatric care setting, SUD status, age, and cause of death.
• The result: Among diagnosed people aged 5–64, 46.1% showed rapidly declining excess mortality with little evidence beyond two years, with two-year MRRs spanning 0.88–1.04 in men and 0.92–1.12 in women, while excess persisted in specialist care and was particularly high with SUD.

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