People diagnosed with schizophrenia or bipolar disorder may live up to 20 years less than the general population, and the biggest driver is not what many assume. New research from the University of Queensland, published in The Lancet Psychiatry in August 2026, points instead to preventable physical illnesses that build up years before they are noticed.
Psychiatry registrar and doctoral candidate Dr. Sean Halstead and colleagues analyzed 24 years of Queensland hospital data covering nearly 180,000 patients, roughly 30,000 of them living with severe mental illness. Across 11 major disease categories, from cardiovascular and respiratory conditions to metabolic and neurological disorders, rates of illness ran substantially higher and appeared far earlier in life.
According to Halstead, many people have assumed the shorter life expectancy tied to schizophrenia or bipolar disorder is mostly due to suicide, but much of the gap is actually driven by physical illnesses, many of which are preventable or treatable.
Where the years are actually lost
The pattern is well documented in US data too. The National Institute of Mental Health puts the average potential life lost for a person with schizophrenia in the United States at 28.5 years, and notes that co-occurring conditions such as heart disease, liver disease and diabetes drive much of the higher premature mortality.
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Suicide is real and serious, but it accounts for a smaller share than many people assume. NIMH estimates that about 4.9 percent of people with schizophrenia die by suicide. The rest of the mortality gap sits with the body.
Cardiovascular disease is the single largest contributor. A comparative risk assessment published in Schizophrenia Bulletin found that schizophrenia more than doubles the risk of dying from ischemic heart disease (relative risk 2.36) and quadruples the risk of dying from diabetes (relative risk 4.08). Stroke risk is nearly doubled.
Why the body suffers earlier
Professor Dan Siskind, senior researcher on the Queensland study, said the evidence points to a combination of factors, including genetics, medication side effects, higher rates of smoking and alcohol use, challenges accessing health care, and the tendency for physical symptoms to be overlooked in people with severe mental illness.
The pattern shows up young. The Queensland team found the biggest impact on physical health in younger adults, especially women under 25. That mirrors earlier work from the same group, which reported that adults under 40 with severe mental illness are more than four times as likely to already have two or more chronic physical conditions.
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What integrated care looks like
The researchers argue for a shift in how psychiatric care is organized. Halstead has said doctors need to be thinking about physical health from the moment severe mental illness is diagnosed, because by the time physical conditions emerge, opportunities for prevention may already have been missed.
In practice, that means routine screening for blood pressure, blood sugar and cholesterol, support to quit smoking, and closer attention to the metabolic side effects of antipsychotic medication. It also means primary care teams and mental health teams sharing information rather than working in parallel silos.
What it means for families
An estimated 15.4 million American adults, about 6 percent, live with a serious mental illness, so the mortality gap touches millions of families. The Queensland findings do not change the diagnosis, but they reframe what good care should include.
Anyone living with schizophrenia or bipolar disorder, or supporting someone who is, can ask their care team for a physical health review alongside psychiatric treatment, and raise physical symptoms such as chest pain, breathlessness or unexplained weight change with a doctor early rather than late.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.