Mortality in a Follow-up of 500 Psychiatric Outpatients

Martin, Ronald L.; Cloninger, C. Robert; Guze, Samuel B.; Clayton, Paula J.

doi:10.1001/archpsyc.1985.01790240060006

Cited by 224 publications

(108 citation statements)

References 31 publications

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“…resentative community samples have generally 1969; Rorsman, 1974;Black et al 1985; Martin confirmed an increased mortality rate in persons et al 1985 and others), especially patients treated who had previously shown signs of mental for dementia (Jagger & Clarke, 1988;Jorm et al illness. Rorsman et al (1982) reported from the 1991) and patients treated for alcohol abuse Lundby study in Sweden a relative death rate or dependency have shown excess mortality from natural causes (death rate in mentally (Berglund, 1984;Martin et al 1985). The issue ill/death rate in standard population) of 1-5 of excess mortality in patients with a psychiatric among men and 1-2 among women with a background of mental disorder; they found no excess mortality among neurotics.…”

Section: Ilvt1mentioning

confidence: 98%

Mortality risk and mental disorders: longitudinal results from the Upper Bavarian Study

Fichter

Rehm²,

Elton³

et al. 1995

Psychol. Med.

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SynopsisThe object of the study was the assessment of the mortality risk for persons with a mental disorder in an unselected representative community sample assessed longitudinally. Subjects from a rural area in Upper Bavaria (Germany) participated in semi-structured interviews conducted by research physicians in the 1970s (first assessment) and death-certificate diagnoses were obtained after an interval up to 13 years later. The sample consisted of 1668 community residents aged 15 years and over.Cox regression estimates resulted in an odds ratio of 1·35 (confidence interval 1·01 to 1·81) for persons with a mental disorder classified as marked to very severe. The odds ratio increased with increasing severity of mental illness from 1·04 for mild disorders, 1·30 for marked disorders, to 1·64 for severe or very severe disorders. The relative risk (odds ratio) for persons with a mental disorder only and no somatic disorder was 1·22, for persons with only a somatic disorder 2·00, and for those with both a mental and a somatic disorder 2·13. The presence of somatic illness was responsible for most of the excess mortality. Somatic disorders associated with excess mortality in mental disorders were diseases of the nervous system or sensory organs, diseases of the circulatory system, diseases of the gastrointestinal tract, and diseases of the skeleton, muscles and connective tissue (ICD-8).Thus, while mental illness alone had a limited effect on excess mortality, comorbidity with certain somatic disorders had a significant effect.

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Section: Ilvt1mentioning

confidence: 98%

Mortality risk and mental disorders: longitudinal results from the Upper Bavarian Study

Fichter

Rehm²,

Elton³

et al. 1995

Psychol. Med.

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“…The use of out-patient as well as in-patient data is important because it allows the inclusion of individuals with milder mental disorders who do not require admission to hospital, enabling more reliable and generalisable risk estimates. Most previous studies of this issue were based on either hospital discharge data 9,10 or smaller case-control 11 or communitybased [12][13][14][15] samples, and varied widely in adjustment for confounding. Our overall risk estimates were higher than the two-to fivefold increased risks of accidental death among psychiatric patients reported in those studies, possibly due to better ascertainment and reduced misclassification of mental disorders.…”

Section: Main Findingsmentioning

confidence: 99%

“…Previous studies of this issue have had important limitations, including the use of only hospitalised psychiatric cases, 9,10 or small sample sizes in case-control 11 or other community-based [12][13][14][15][16] studies. We conducted the largest study of this issue to date using data for the entire adult population of Sweden (~6.9 million).…”

mentioning

confidence: 99%

Mental disorders and risk of accidental death

et al. 2013

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BackgroundLittle is known about accidental death risks among psychiatric patients.AimsTo examine this issue in the most comprehensive study to date.MethodNational cohort study of all Swedish adults (n = 6 908 922) in 2001–2008.ResultsThere were 22 419 (0.3%) accidental deaths in the total population, including 5933 (0.9%) accidental deaths v. 3731 (0.6%) suicides among psychiatric patients (n = 649 051). Of persons who died from accidents, 26.0% had any psychiatric diagnosis v. 9.4% in the general population. Accidental death risk was four- to sevenfold among personality disorders, six- to sevenfold among dementia, and two- to fourfold among schizophrenia, bipolar disorder, depression or anxiety disorders, and was not fully explained by comorbid substance use. Strong associations were found irrespective of sociodemographic characteristics, and for different types of accidental death (especially poisoning or falls).ConclusionsAll mental disorders were strong independent risk factors for accidental death, which was substantially more common than suicide.

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“…Moreover, there are other problems in securing unbiased estimates. Persons who develop schizophrenia, antisocial personality, substance use disorders (including alcoholism), and some neurotic types of disorder as well, tend to die young (e.g., Martin et al, 1985;Kendler, 1986), be hospitalized, imprisoned, and/or move residence frequently. Such persons are likely to be under-represented in the crosssectional samples of household members who are selected for study in most epidemiological research on psychiatric disorders in the general population.…”

mentioning

confidence: 99%

Socioeconomic status and psychiatric disorders: an update on the social causation - social selection issue

Dohrenwend¹

1993

Epidemiol Psichiatr Soc

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Mortality in a Follow-up of 500 Psychiatric Outpatients

Cited by 224 publications

References 31 publications

Mortality risk and mental disorders: longitudinal results from the Upper Bavarian Study

Mortality risk and mental disorders: longitudinal results from the Upper Bavarian Study

Mental disorders and risk of accidental death

Socioeconomic status and psychiatric disorders: an update on the social causation - social selection issue

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