Cause-specific mortality in psychiatric patients after deinstitutionalisation.
BACKGROUND
Since the late 1970s, the psychiatric service system in Norway has been changed gradually according to the principles of deinstitutionalisation.


OBJECTIVE
To document the mortality of psychiatric patients in a deinstitutionalised service system.


METHODS
The case register of a psychiatric hospital covering the period 1980-1992 was linked to the Central Register of Deaths. Age-adjusted death rates and standardised mortality ratios (SMRs) were computed.


RESULTS
Patients with organic psychiatric disorders had significantly higher mortality regardless of cause of death. SMRs ranged from 0.9 for death by cancer in women to 36.3 for suicide in men. For unnatural death, SMRs were highest in the first year after discharge. Compared to the periods 1950-1962 and 1963-1974, there has been an increase in SMRs for cardiovascular death and suicide in both genders.


CONCLUSIONS
Deinstitutionalisation seems to have had as its cost a relative rise both in cardiovascular death and unnatural deaths for both genders, but most pronounced in men.
Hansen
V
V
Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. vidje.hansen@ism.uit.no
Jacobsen
B K
BK
Arnesen
E
E
D017677:Age Distribution; D002423:Cause of Death; D003688:Deinstitutionalization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000401:mortality*; D009664:Norway / Q000453:epidemiology; D017678:Sex Distribution; D015996:Survival Rate