BACKGROUND: Most mortality studies of psychiatric patients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatric patients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services. METHOD: All subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population. RESULTS: The overall SMR of the psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95% confidence interval (CI) 1.6-1.8], and higher still following the first admission (SMR 2.61, 95% CI 2.4-2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95% CI 142.5-328.6) and personality disorders (20.87, 95% CI 5.2-83.4). CONCLUSIONS: This study found that psychiatric patients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.
BACKGROUND: Most mortality studies of psychiatricpatients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatricpatients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services. METHOD: All subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population. RESULTS: The overall SMR of the psychiatricpatients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95% confidence interval (CI) 1.6-1.8], and higher still following the first admission (SMR 2.61, 95% CI 2.4-2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95% CI 142.5-328.6) and personality disorders (20.87, 95% CI 5.2-83.4). CONCLUSIONS: This study found that psychiatricpatients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.
Authors: Kate M Scott; Carmen Lim; Ali Al-Hamzawi; Jordi Alonso; Ronny Bruffaerts; José Miguel Caldas-de-Almeida; Silvia Florescu; Giovanni de Girolamo; Chiyi Hu; Peter de Jonge; Norito Kawakami; Maria Elena Medina-Mora; Jacek Moskalewicz; Fernando Navarro-Mateu; Siobhan O'Neill; Marina Piazza; José Posada-Villa; Yolanda Torres; Ronald C Kessler Journal: JAMA Psychiatry Date: 2016-02 Impact factor: 21.596
Authors: Lisa Mather; J Narusyte; A Ropponen; G Bergström; V Blom; B Helgadóttir; P Svedberg Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2019-05-10 Impact factor: 4.328
Authors: Mohammadreza Mohebbi; Bruno Agustini; Robyn L Woods; John J McNeil; Mark R Nelson; Raj C Shah; Van Nguyen; Elsdon Storey; Anne M Murray; Christopher M Reid; Brenda Kirpach; Rory Wolfe; Jessica E Lockery; Michael Berk Journal: Int J Geriatr Psychiatry Date: 2019-05-08 Impact factor: 3.485
Authors: Wendy Madarasz; Ann Manzardo; Erik Lykke Mortensen; Elizabeth Penick; Joachim Knop; Holger Sorensen; Ulrik Becker; Elizabeth Nickel; William Gabrielli Journal: Can J Psychiatry Date: 2012-08 Impact factor: 4.356