No comprehensive study has yet been made of mortality among psychiatric patients in Finland. According to studies conducted in other parts of the world, the mortality rates of psychiatric patients are higher than those of the general population. The study population here consisted of all patients discharged from psychiatric hospitals during the year 1988 (n = 22940). The register follow-up of these patients extended up to the year 1992. In the course of the follow-up a total of 3936 discharged psychiatric patients died (17.2%). The standardized mortality ratio (SMR) of the patients discharged from psychiatric hospitals was almost four times higher than that of the general population. The proportion of unnatural causes of death, including accidents in the young age groups and especially the much higher suicide SMR among young women, is a particularly striking finding. Natural causes of death were also more prevalent among the study population than in the general population, the major causes being acute myocardial infarction and unspecified pneumonia. The results of this study confirm previous findings of increased mortality among psychiatric patients compared to the general population. On the basis of this study one cannot, however, conclude that the reason for the high mortality rate would be premature discharge. More attention needs to be paid to the care of young patients and to supporting the patient during the transition from the hospital to community care.

BackgroundFew epidemiological studies have focused on the occurrence of positive mental health, and those comparing several countries practically non-existent. This study presents comparative findings of positive mental health in 11 EU countries or regions, based on the Eurobarometer 2002 (autumn) survey.MethodThe sample (n = 10,878) represents the general population, aged 15 or over, of 11 European countries or regions (all old EU Member States except Denmark, Greece, Ireland, Finland and Great Britain which had to be excluded because of poor response rate, less than 45%). The method of opinion survey was applied using face-to-face interviews. The Energy and Vitality Index (EVI) from the SF-36 questionnaire was use as measure of positive mental health.ResultsOverall, there were between-country differences in the gender- and age-adjusted EVI mean scores. In general, poorer mental health was found in women, older age groups, those in poor economic position and those experiencing weak social support.ConclusionMethodological biases cannot be fully excluded, and thus, one has to take the presented results with certain caution, especially when comparing the results from the different countries. On the other hand, the results on the determinants of positive mental health are in concordance with most previous studies.

Background: The characteristics of victims of immediate post-discharge suicides are not well known. We explored these characteristics for the purposes of better recognition and preventive efforts of potential immediate post-discharge suicides.

The restructuring and downsizing of mental health services was not associated with any increase in suicides immediately (one week) or one year postdischarge. Instead, the risk of these suicides decreased significantly between the two time periods among several diagnostic categories. Although the role of psychiatric hospitalization in general may have changed over time, patients who are hospitalized now may be less suicidal after discharge. Our results indicate, in terms of postdischarge suicides, that the downsizing of psychiatric hospitals has been a success. However, there is still a substantial need for better recognition of suicidal risk among psychiatric patients.

About 3% of the working-age population experience an episode of depressive disorder each year. Due to recall problems, the estimate of first-time incidence may be too high.