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Author summary Why was this study done? Patients with severe mental illness (SMI) have been reported to have excess mortality from sepsis (number of deaths due to sepsis in the whole population). Whether SMI is associated with higher or lower sepsis-associated case fatality remains unclear (number of deaths due to sepsis in the population with sepsis). No study has determined whether SMI is associated with excess case fatality in patients with septic shock, the most severe form of sepsis when accounting for the most relevant confounding variables. What did the researchers do and find? In this nationwide, population-based cohort study, we compared 30-, 90-, and 365-day case fatality rates (CFRs) in septic shock patients with and without SMI admitted to the intensive care unit (ICU). We identified 187,587 adult patients with septic shock admitted to the ICU, including 3,812 with schizophrenia, 2,258 with bipolar disorder, and 5,246 with major depressive disorder. The 30-, 90-, and

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