Discussion The proposed core outcome set will provide clear guidance about what outcomes should be measured , as a minimum , in trials of interventions for people with coexisting type-2 diabetes and SMI , and improve future synthesis of trial evidence in this area .
Background People with diabetes and comorbid severe mental illness ( SMI ) form a growing population at risk of increased mortality and morbidity compared to those with diabetes or SMI alone .
There is increasing interest in interventions that target diabetes in SMI in order to help to improve physical health and reduce the associated health inequalities .
However , there is a lack of consensus about which outcomes are important for this comorbid population , with trials differing in their focus on physical and mental health .
A core outcome set , which includes outcomes across both conditions that are relevant to patients and other key stakeholders , is needed .
Twenty-five year mortality of a community cohort with schizophrenia.
BACKGROUND People with schizophrenia have significantly raised mortality but we do not know how these mortality patterns in the UK have changed since the 1990s . AIMS To measure the 25-year mortality of people with schizophrenia with particular focus on changes over time . METHOD Prospect i ve record linkage study of the mortality of a community cohort of 370 people with schizophrenia . RESULTS The cohort had an all-cause st and ardised mortality ratio of 289 ( 95 % CI 247 - 337 ) . Most deaths were from the common causes seen in the general population . Unnatural deaths were concentrated in the first 5 years of follow-up . There was an indication that cardiovascular mortality may have increased relative to the general population ( P = 0.053 ) over the course of the study . CONCLUSIONS People with schizophrenia have a mortality risk that is two to three times that of the general population . Most of the extra deaths are from natural causes . The apparent increase in cardiovascular mortality relative to the general population should be of concern to anyone with an interest in mental health
Discussion The proposed core outcome set will provide clear guidance about what outcomes should be measured , as a minimum , in trials of interventions for people with coexisting type-2 diabetes and SMI , and improve future synthesis of trial evidence in this area .
Background People with diabetes and comorbid severe mental illness ( SMI ) form a growing population at risk of increased mortality and morbidity compared to those with diabetes or SMI alone .
There is increasing interest in interventions that target diabetes in SMI in order to help to improve physical health and reduce the associated health inequalities .
However , there is a lack of consensus about which outcomes are important for this comorbid population , with trials differing in their focus on physical and mental health .
A core outcome set , which includes outcomes across both conditions that are relevant to patients and other key stakeholders , is needed .