Reducing all-cause mortality among patients with psychiatric disorders: a population-based study

Kisely, Steve; Preston, Neil; Xiao, Jianguo; Lawrence, David; Louise, Sandra; Crowe, Elizabeth

doi:10.1503/cmaj.121077

Cited by 59 publications

(69 citation statements)

References 24 publications

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“…95 Long-term predictions and generalizability are also problematic because of the network of intervening factors and shifting definitions of concussion. 47,96,97 Some patients with concussion receive care that may mitigate the risk of suicide, such as antidepressant medication; 98,99 however, our study lacked data on such care, which remains a topic for future research.…”

Section: Limitationsmentioning

confidence: 99%

Risk of suicide after a concussion

Fralick

Thiruchelvam

Tien

et al. 2016

CMAJ

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Section: Limitationsmentioning

confidence: 99%

Risk of suicide after a concussion

Fralick

Thiruchelvam

Tien

et al. 2016

CMAJ

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“…6 CTO patients had greater overall health service use in both the year prior to CTO placement, and to the implementation of CTOs in 1997. 6 There were no other differences, including length of psychiatric history prior to CTO. 6 Among the sample, 472 underwent a specialized procedure occurring before their index date and so were excluded.…”

Section: Resultsmentioning

confidence: 95%

“…CTO patients were more likely to have been always single and born outside Australia. 6 They were less likely to be engaged in work, study, or home duties, or to have been admitted for nonpsychiatric reasons, a measure of physical comorbidity. 6 CTO patients had greater overall health service use in both the year prior to CTO placement, and to the implementation of CTOs in 1997.…”

Section: Resultsmentioning

confidence: 99%

“…We used the same sample as the previous study 6 that reported a reduced mortality from physical illness in CTO cases. Everyone placed on a CTO from 1997 to 2008 was compared with control subjects not on CTOs.…”

Section: Methodsmentioning

confidence: 99%

“…These 3 time intervals also coincided with those in our earlier comparison of mortality in CTO patients and control subjects. 6 We used matching, multivariate, and propensity score techniques to consider sociodemographic factors, clinical features, and previous health service use. We adjusted for psychiatric service use prior to both CTO implementation in 1997, and CTO index date, in terms of psychiatric admissions (especially involuntary), bed days, and outpatient contacts.…”

Section: Methodsmentioning

confidence: 99%

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Is the Effect of Compulsory Community Treatment on Preventable Deaths from Physical Disorders Mediated by Better Access to Specialized Medical Procedures?

et al. 2014

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Objectives: Compulsory community treatment has been shown to reduce preventable deaths from physical disorders-these causes being up to 10 times more common than suicide in psychiatric patients. We investigated whether this was mediated by better access to specialized medical procedures.Method: All patients on compulsory community treatment for over 11 years were compared with matched control subjects using linked administrative health data from Western Australia (state population of about 2.24 million). Outcomes were access to revascularization and other specialized procedures at 1-, 2-, and 3-year follow-up. Logistic regression was used to adjust for demographics, prior health service use, diagnosis, and length of psychiatric history.Results: There were 2757 patients and 2687 control subjects (total n = 5444). Sixty-five per cent were males (n = 3522), and the average age was 36 years (SD 13.2). Most had schizophrenia or other nonaffective psychoses (74%), followed by affective disorders (26%). At 2-year follow-up, 2% (n = 53) of patients and 2.6% (n = 69) of control subjects had undergone a specialized intervention. Compulsory community treatment did not result in greater access to specialized procedures at all 3 time points even after adjusting for potential confounders. Conclusions:Greater access to specialized procedures does not explain the reduced mortality from preventable physical illness that had been reported in patients on community treatment orders. There must be other explanations for this finding, such as mental health staff facilitating access to chronic disease management in primary care. This warrants further research. W W WL'effet du traitement obligatoire en milieu communautaire sur les décès évitables de maladies physiques est-il favorisé par un meilleur accès aux procédures médicales spécialisées?Objectifs : Le traitement obligatoire en milieu communautaire s'est révélé réduire les décès évitables de maladies physiques, lesquels étant jusqu'à 10 fois plus fréquents que le suicide chez les patients psychiatriques. Nous avons recherché si cela était favorisé par un meilleur accès aux procédures médicales spécialisées.Méthode : Tous les patients soumis à un traitement obligatoire en milieu communautaire pendant plus de 11 ans ont été comparés avec des sujets témoins appariés à l'aide des données conjointes de santé et administratives d'Australie-Occidentale (population de quelque 2,24 millions). Les résultats étaient l'accès à la revascularisation et à d'autres procédures spécialisées aux suivis de 1, 2 et 3 ans. La régression logistique a servi à ajuster les données démographiques, l'utilisation précédente des services de santé, le diagnostic, et la durée des antécédents psychiatriques.

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Compulsory community and involuntary outpatient treatment for people with severe mental disorders

Kisely

Campbell

2014

Cochrane Database of Systematic Reviews

120

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CCT results in no significant difference in service use, social functioning or quality of life compared with standard voluntary care. People receiving CCT were, however, less likely to be victims of violent or non-violent crime. It is unclear whether this benefit is due to the intensity of treatment or its compulsory nature. Short periods of conditional leave may be as effective (or non-effective) as formal compulsory treatment in the community. Evaluation of a wide range of outcomes should be considered when this legislation is introduced. However, conclusions are based on three relatively small trials, with high or unclear risk of blinding bias, and evidence we rated as low to medium quality.

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Reducing all-cause mortality among patients with psychiatric disorders: a population-based study

Cited by 59 publications

References 24 publications

Risk of suicide after a concussion

Risk of suicide after a concussion

Is the Effect of Compulsory Community Treatment on Preventable Deaths from Physical Disorders Mediated by Better Access to Specialized Medical Procedures?

Compulsory community and involuntary outpatient treatment for people with severe mental disorders

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