Mortality among persons with a history as psychiatric inpatients with functional psychosis.
BACKGROUND
An important aim in all psychiatric care should be a reduction of overall mortality. Information on mortality patterns in different types of psychiatric populations is vital for a successful design of treatment strategies and preventive programmes. The present study aims to describe mortality among persons with a history as psychiatric inpatients with functional psychosis.


METHODS
All psychiatric inpatients, 17,878 men and 23,256 women, registered in the Swedish National Hospital Discharge Registry between 1978 and 1982 with a functional psychosis (ICD-8 = 295-299) as principal diagnosis were followed for mortality during the time period 1983-85. Life tables were constructed and death rates for various types of causes of death were calculated.


RESULTS
Compared to the general population, the excess mortality in the study group caused a reduction in life expectancy of 22.1-27.9% (95% CI) among the men and 15.0-21.7% among the women. In the age group 2049 years, 62% of the excess mortality was caused by suicide. In the age group 50-89 years, only 8% of the excess was suicide, while 52% was caused by cardiovascular disorders.


CONCLUSIONS
Reduction in mortality rates requires different strategies in different age groups. Even if the suicide rate were reduced to zero, it would only have a marginal influence on the highly elevated mortality among patients in upper middle age and among the elderly. Among the younger patients (<35 years), on the other hand, practically all excess mortality was caused by suicide and accidents.
Hannerz
H
H
Department of Epidemiology and Surveillance, National Institute of Occupational Health, Copenhagen, Denmark. hh@ami.dk
Borgå
P
P
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D008017:Life Expectancy; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000401:mortality*; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology