Mortality among Elderly Psychiatric Patients: Basis for Preventive Intervention

Craig, Thomas J.; Shang, Lin

doi:10.1111/j.1532-5415.1981.tb01762.x

Cited by 12 publications

(4 citation statements)

References 20 publications

(42 reference statements)

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“…Indirect evidence consistent with this premise is provided by the remarkably high mortality rates for elderly psychiatric patients from pneumonia: within the first year after psychiatric admission, there are fifty times more deaths from this infectious disease than found among agematched general population counterparts. The ratio drops to twenty times that of their age-matched counterparts by the second year of institutionalization, suggesting that the hospital environment per se may be a less critical factor in mortality than the transition (53). In this context it should be noted that depression is the leading reason for psychiatric hospitalization in the elderly (54).…”

Section: Discussionmentioning

confidence: 96%

Chronic stress and immunity in family caregivers of Alzheimerʼs disease victims.

Kiecolt‐Glaser

Glaser

Shuttleworth

et al. 1987

Psychosomatic Medicine

452

191

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Although acute stress has been associated with transient immunosuppression, little is known about the immunologic consequences of chronic stress in humans. In order to investigate possible health-related consequences of a long-term stressor, we obtained blood samples for immunologic and nutritional analyses and psychologic data from 34 family caregivers of Alzheimer's disease (AD) victims and 34 sociodemographically matched comparison subjects. Family caregivers for AD victims were more distressed than comparison subjects without similar responsibilities. Greater impairment in the AD victim was associated with greater distress and loneliness in caregivers. Caregivers had significantly lower percentages of total T lymphocytes and helper T lymphocytes than did comparison subjects, as well as significantly lower helper-suppressor cell ratios; caregivers also had significantly higher antibody titers to Epstein-Barr virus than did comparison subjects, presumably reflecting poorer cellular immune system control of the latent virus in caregivers. The percentages of natural killer cells and suppressor T lymphocytes did not differ significantly. These data suggest that chronically stressed AD family caregivers do not show immunologic or psychologic adaptation to the level of their well-matched age peers.

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Section: Discussionmentioning

confidence: 96%

Chronic stress and immunity in family caregivers of Alzheimerʼs disease victims.

Kiecolt‐Glaser

Glaser

Shuttleworth

et al. 1987

Psychosomatic Medicine

452

191

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show abstract

“…Most people with depression in the community do not receive any specific treatment for depressive symptoms (Schoevers et al , 2000). Two early studies suggest that treatment of depression may lower mortality, especially in men (Avery & Winokur, 1976; Craig & Lin, 1981). The findings here, together with the previous literature, suggest the need to investigate the effect on mortality of vigorous treatment of confirmed depression.…”

Section: Discussionmentioning

confidence: 99%

Depression and mortality in a high-risk population

Abas¹,

Hotopf

Prince³

2002

Br J Psychiatry

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BackgroundIt is not clear whether the increased mortality associated with depression can be explained by the effects of potential confounding variables.AimsTo measure the effect of depression on mortality after controlling for cognitive decline, cardiovascular risk factors and antidepressant use.MethodA prospective cohort study derived from data from a multi-centre randomised controlled trial of moderate hypertension. Atotal of2584 participants, aged 65–75 years at study entry, were followed up for 11 years.ResultsDepression on the SelfCARE-D scale was associated with mortality after controlling for gender. After controling for cardiovascular risk factors, cognitive decline and anti-depressant use, depression continued to have a modest effect (hazard ratio⩵l.43; 95% CI 1.03–1.98). Depression in males and in people aged under 70 years significantly increased the risk of death.ConclusionsDepression was associated with mortality only after controlling for gender. There was a modest but robust association between depression and mortality that was not explained by confounding by cardiovascular risk factors, cognitive decline or history of antidepressant use.

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“…Studies that include only inpatients who died while undergoing psychiatric care (3)(4)(5)(6)(7)(8)(9)(10) show higher patient mortality than studies which include deaths of discharged patients. Reported overall mortality ratios range from 1.4 to 7.5 for females and from 1.4 to 6.8 for males.…”

mentioning

confidence: 99%

Mortality variations among public mental health patients

Wood¹,

Evenson²,

Cho³

et al. 1985

Acta Psychiatr Scand

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Earlier studies of mortality of psychiatric patients are reviewed, and agreements and inconsistencies related to age, sex, diagnosis and cause of death are noted. The authors then analyze 5,268 deaths during a 5-year period of current or former patients in Missouri public psychiatric hospitals and mental health clinics, calculating mortality ratios that are simultaneously age-, sex-, diagnostic-, and cause-specific. The results are used to construct a quantitative model. The ratios vary most with cause, then diagnosis, least with sex. Influenza and pneumonia contribute most to patient mortality; patient death rates for cancer are lower than population rates at all ages. There are substantial interactions of diagnosis with cause and sex. Among those diagnosed organic brain syndrome, who have the highest overall ratios, the ratios are extra high for females and for influenza and pneumonia, relatively low for external causes.

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Mortality among Elderly Psychiatric Patients: Basis for Preventive Intervention

Cited by 12 publications

References 20 publications

Chronic stress and immunity in family caregivers of Alzheimerʼs disease victims.

Chronic stress and immunity in family caregivers of Alzheimerʼs disease victims.

Depression and mortality in a high-risk population

Mortality variations among public mental health patients

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