D Lawrence1, A V Jablensky, C D Holman, T J Pinder. 1. Centre for Health Services Research, Department of Public Health, The University of Western Australia, Nedlands, Australia. davidl@dph.uwa.edu.au
Abstract
BACKGROUND: The aim was to examine mortality in psychiatric patients in Western Australia (WA), over a time period of considerable change in the delivery of mental health services. METHODS: A population-based record linkage analysis was undertaken to quantify mortality among people with mental illness in WA. Mortality rates were calculated in users of mental health services and compared with rates in the whole population of WA. Trends in mortality were also examined using relative survival analysis, and proportional hazards regression. RESULTS: The overall mortality rate ratio was 2.57 in males (95% CI: 2.51-2.64), and 2.18 in females (2.12-2.24). The highest cause-specific mortality rate ratio was for deaths due to suicide [RR: 7.37 in males (95% CI: 6.74-8.05) and 8.38 in females (95% CI: 7.11-9.89)], with mortality rate ratios being significantly greater than 1 for all other major causes of death. A relative survival analysis found that the excess mortality risk was concentrated in the first few years after first contact with mental health services. Proportional hazards regression analysis found a slight elevation of mortality rates over time. CONCLUSIONS: Mortality among psychiatric patients remains high and appears to be increasing. Highest excess mortality rate is associated with suicide, but mortality rates are significantly elevated for all major causes of death.
BACKGROUND: The aim was to examine mortality in psychiatricpatients in Western Australia (WA), over a time period of considerable change in the delivery of mental health services. METHODS: A population-based record linkage analysis was undertaken to quantify mortality among people with mental illness in WA. Mortality rates were calculated in users of mental health services and compared with rates in the whole population of WA. Trends in mortality were also examined using relative survival analysis, and proportional hazards regression. RESULTS: The overall mortality rate ratio was 2.57 in males (95% CI: 2.51-2.64), and 2.18 in females (2.12-2.24). The highest cause-specific mortality rate ratio was for deaths due to suicide [RR: 7.37 in males (95% CI: 6.74-8.05) and 8.38 in females (95% CI: 7.11-9.89)], with mortality rate ratios being significantly greater than 1 for all other major causes of death. A relative survival analysis found that the excess mortality risk was concentrated in the first few years after first contact with mental health services. Proportional hazards regression analysis found a slight elevation of mortality rates over time. CONCLUSIONS: Mortality among psychiatricpatients remains high and appears to be increasing. Highest excess mortality rate is associated with suicide, but mortality rates are significantly elevated for all major causes of death.
Authors: Helena Rantanen; Anna-Maija Koivisto; Raimo K R Salokangas; Mika Helminen; Hannu Oja; Sami Pirkola; Kristian Wahlbeck; Matti Joukamaa Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2008-07-28 Impact factor: 4.328
Authors: Jie Lin; Katherine A McGlynn; Corey A Carter; Joel A Nations; William F Anderson; Craig D Shriver; Kangmin Zhu Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-08-26 Impact factor: 4.254
Authors: Heidi Honkonen; Aino K Mattila; Klaus Lehtinen; Teemu Elo; Riina Haataja; Matti Joukamaa Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2008-05-13 Impact factor: 4.328
Authors: Nicholas Chak Lam Yung; Corine Sau Man Wong; Joe Kwun Nam Chan; Eric Yu Hai Chen; Wing Chung Chang Journal: Schizophr Bull Date: 2021-03-16 Impact factor: 9.306