Life expectancy in people with depression
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Depression and Reduced Life Expectancy: Global Evidence
Research consistently shows that people with depression have a significantly shorter life expectancy compared to those without depression, across diverse populations and countries 1234+5 MORE.
Quantifying Life Expectancy Loss in Depression
Studies from Denmark, Canada, China, and the US report that depression is associated with a reduction in life expectancy ranging from about 1.8 to 14 years, depending on the population, age at onset, and severity of depression 1234+3 MORE. For example, Danish data show that men with unipolar depression may lose up to 14 years of life, and women up to 10 years, compared to the general population . In Canada, healthy life expectancy at age 20 is 15 years lower for women and nearly 15 years lower for men with recent major depression compared to those without . In China, middle-aged and older adults with depressive symptoms lose about 1.8 to 2.6 years of total life expectancy at age 45, with even greater reductions in years lived without disability or in self-assessed good health .
Causes of Excess Mortality and Life-Years Lost
The increased mortality in people with depression is due to both natural and unnatural causes. Natural causes include cardiovascular disease, respiratory disease, and cancer, which account for most deaths 134. Unnatural causes, especially suicide, contribute disproportionately to the life expectancy gap, particularly among younger people and those with severe or treatment-resistant depression 1348. For instance, suicide-specific mortality is up to eight times higher in people with depression, and even higher among young adults 1348.
Alcohol-related deaths are also a significant contributor to the life expectancy gap, especially in countries with high alcohol-related mortality and among men 410. In Denmark and Finland, alcohol-related deaths account for up to a third of the life expectancy gap in people with depression .
Impact on Quality-Adjusted and Disability-Free Life Expectancy
Depression not only shortens life but also reduces the number of years lived in good health. Quality-adjusted life expectancy (QALE) and health-adjusted life expectancy (HALE) are much lower in people with depression, with much of the gap explained by lower health-related quality of life, in addition to premature mortality 27. In the US, adults with depression at age 18 have a QALE nearly 29 years lower than those without depression . Similarly, disability-free life expectancy is reduced by several years in people with depressive symptoms, and this reduction increases with age 69.
Special Populations: Treatment-Resistant Depression and Working Life
People with treatment-resistant depression have even higher mortality and shorter life expectancy than those with less severe depression, with suicide accounting for most of the excess life-years lost . Depression also impacts working life expectancy, with those experiencing persistent or episodic depressive symptoms expected to be employed 5–17 years less than those with low symptoms, and disparities are greater among racial/ethnic minorities and those with lower education .
Conclusion
Depression is strongly linked to reduced life expectancy and fewer years lived in good health, with the gap driven by both natural and unnatural causes, including suicide and alcohol-related deaths. The impact is especially severe in men, younger adults, and those with severe or treatment-resistant depression. These findings highlight the urgent need for effective interventions to improve both mental and physical health and to reduce suicide risk in people with depression 1234+5 MORE.
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Most relevant research papers on this topic
Excess mortality and life-years lost in people diagnosed with depression: A 20-year population-based cohort study of 126,573 depressed individuals followed for 1,139,073 persons-years.
Depression is associated with increased premature mortality and reduced lifespan in a predominantly Chinese population, mainly due to natural causes, with suicide-specific mortality being significantly elevated.
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Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada.
Depression in adults in Canada leads to lower healthy life expectancy, primarily due to lower health-related quality of life, but also due to premature mortality.
The working life expectancy of American adults experiencing depression
Depression in adults can lead to shorter working lives, with individuals experiencing episodic symptoms and experiencing a shorter working life expectancy at age 30 compared to those without depression.
Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study.
Treatment-resistant depression (TRD) leads to higher mortality rates and shorter life expectancy, with suicide being the main cause of Life Years Lost.
The impact of depressive symptoms and chronic diseases on active life expectancy in older Americans.
Depressive symptoms significantly shorten active life expectancy in older adults, regardless of chronic diseases, and timely diagnosis and treatment may delay disability and improve quality of life.
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