Mortality in individuals who have had psychiatric treatment: population-based study in Nova Scotia.
BACKGROUND
Most studies of mortality in psychiatric patients have investigated in-patients rather than those attending out-patient clinics or primary care, where most receive treatment.


OBJECTIVE
To evaluate the mortality risk in mental illness for patients in contact with psychiatric services or primary care (n=221 048) across Nova Scotia (population 936 025).


METHODS
A population-based record-linkage analysis was made of the period 1995-2000, using an inception cohort to calculate mortality rate ratios.


RESULTS
The mortality rate was 1.74, with increased ratios for all major causes of death. Male mortality was almost double that of females after controlling for demographic factors, treatment setting and place of residence. Patients of lower income, in specialist psychiatric settings, and with dementia or psychoses were also at greater risk. However, in absolute numbers, 72% of deaths occurred in patients who had only seen their general practitioner.


CONCLUSIONS
Mortality risk is increased in all psychiatric patients, not just those who have received in-patient treatment.
Kisely
Stephen
S
Dalhousie University, Abbie J. Lane Memorial Building, 5909 Veteran's Memorial Lane, Suite 9211, Halifax, Nova Scotia B3H 2E2, Canada. Stephen.Kisely@cdha.nshealth.ca
Smith
Mark
M
Lawrence
David
D
Maaten
Sarah
S
D000367:Age Factors; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007182:Income; D008297:Male; D008498:Medical Record Linkage; D001523:Mental Disorders / Q000401:mortality* / Q000628:therapy; D008605:Mental Health Services; D009674:Nova Scotia / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D011320:Primary Health Care; D012307:Risk Factors; D017678:Sex Distribution