title: Excess cause-specific mortality in in-patient-treated individuals with personality disorder: 25-year nationwide population-based study.
abstract: BACKGROUND
  Although personality disorders are associated with increased overall mortality, less is known about cause of death and personality type.
  
  
  OBJECTIVE
  To determine causes of mortality in ICD personality disorders.
  
  
  METHODS
  Based on data from Swedish nationwide registers, individuals admitted to hospital with a primary diagnosis of personality disorder between 1987 and 2011 were followed with respect to mortality until 31 December 2011. Standardised mortality ratios (SMRs) with 95% confidence intervals and underlying causes of death were calculated.
  
  
  RESULTS
  All-cause SMRs were increased, overall and in all clusters, for natural as well as unnatural causes of death. The overall SMR was 6.1 in women and 5.0 in men, as high as previously reported for anorexia nervosa, with higher rates in cluster B and mixed/other personality disorders. The SMR for suicide was 34.5 in women and 16.0 in men for cluster B disorders. Somatic and psychiatric comorbidity increased SMRs.
  
  
  CONCLUSIONS
  The SMR was substantially increased for all personality disorder clusters. Thus, there was an increased premature mortality risk for all personality disorders, irrespective of category.
authors.affiliation: Emma Björkenstam, PhD, Department of Public Health Sciences, Karolinska Institutet, Stockholm and the Department of Evaluation, and Analysis, Epidemiology and Methodological Support Unit, National Board of Health and Welfare, Stockholm, Sweden; Charlotte Björkenstam, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Herman Holm, MD, Department of Psychiatry, Skåne University Hospital, Malmö, Sweden; Bengt Gerdin, MD, PhD, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Lisa Ekselius, MD, PhD, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Björkenstam
authors.affiliation: Emma Björkenstam, PhD, Department of Public Health Sciences, Karolinska Institutet, Stockholm and the Department of Evaluation, and Analysis, Epidemiology and Methodological Support Unit, National Board of Health and Welfare, Stockholm, Sweden; Charlotte Björkenstam, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Herman Holm, MD, Department of Psychiatry, Skåne University Hospital, Malmö, Sweden; Bengt Gerdin, MD, PhD, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Lisa Ekselius, MD, PhD, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Björkenstam
authors.affiliation: Emma Björkenstam, PhD, Department of Public Health Sciences, Karolinska Institutet, Stockholm and the Department of Evaluation, and Analysis, Epidemiology and Methodological Support Unit, National Board of Health and Welfare, Stockholm, Sweden; Charlotte Björkenstam, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Herman Holm, MD, Department of Psychiatry, Skåne University Hospital, Malmö, Sweden; Bengt Gerdin, MD, PhD, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Lisa Ekselius, MD, PhD, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
authors.forename: Herman
authors.initials: H
authors.lastname: Holm
authors.affiliation: Emma Björkenstam, PhD, Department of Public Health Sciences, Karolinska Institutet, Stockholm and the Department of Evaluation, and Analysis, Epidemiology and Methodological Support Unit, National Board of Health and Welfare, Stockholm, Sweden; Charlotte Björkenstam, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Herman Holm, MD, Department of Psychiatry, Skåne University Hospital, Malmö, Sweden; Bengt Gerdin, MD, PhD, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Lisa Ekselius, MD, PhD, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Gerdin
authors.affiliation: Emma Björkenstam, PhD, Department of Public Health Sciences, Karolinska Institutet, Stockholm and the Department of Evaluation, and Analysis, Epidemiology and Methodological Support Unit, National Board of Health and Welfare, Stockholm, Sweden; Charlotte Björkenstam, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Herman Holm, MD, Department of Psychiatry, Skåne University Hospital, Malmö, Sweden; Bengt Gerdin, MD, PhD, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Lisa Ekselius, MD, PhD, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden lisa.ekselius@neuro.uu.se.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death / Q000639:trends*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000401:mortality*; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult