title: Unnatural causes of death and suicide among former adolescent psychiatric patients.
abstract: OBJECTIVE
  Compared with the general population, adolescent psychiatric patients are subject to premature death from all causes, but suicide-specific mortality rates in this population have not been carefully investigated. Therefore, we examined the high mortality due to unnatural causes, particularly suicide, using standardized mortality ratios (SMRs) relative to sex, diagnosis, and type of psychiatric service.
  
  
  METHODS
  A total of 3,029 patients aged 10-19 years presented to the outpatient clinic of a general hospital in Seoul, Korea, or were admitted to that hospital for psychiatric disorders from January 1995 to December 2006. Unnatural causes mortality risk and suicide mortality risk in these patients were compared with those in sex- and age-matched subjects from the general Korean population.
  
  
  RESULTS
  The SMR for unnatural causes was 4.6, and for suicide it was 7.8. Female subjects, the young, and inpatients had the highest risks for unnatural causes of death or suicide. Among the different diagnostic groups, patients with psychotic disorders, affective disorders, and personality disorders had significantly increased SMRs for unnatural causes, and those with psychotic disorders, affective disorders, and disruptive behavioral disorders had significantly increased SMRs for suicide.
  
  
  CONCLUSIONS
  The risks of unnatural death and suicide are high in adolescent psychiatric inpatients in Korea, but not as high in adolescent outpatients. Effective preventative measures are required to reduce suicide mortality in adolescent psychiatric patients, particularly female patients admitted for general psychiatric care.
authors: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Subin
authors: S
authors: Park
authors: Chang Yoon
authors: CY
authors: Kim
authors: Jin Pyo
authors: JP
authors: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D001523:Mental Disorders / Q000453:epidemiology* / Q000401:mortality / Q000534:rehabilitation; D008605:Mental Health Services / Q000706:statistics & numerical data; D061213:Mortality, Premature; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult; D000092864:Suicide Prevention