Changes in mortality among psychiatric inpatients, 1968-1982.

Data based on a national classification of mental disorders were collected continuously between 1968 and 1976, and then every two years from 1976 to 1982, following the same standards, in French public sector psychiatric hospitals. It was possible to study the evolution of deaths over this period taking all causes combined and by psychiatric diagnosis. The hospitalized population was estimated using data on length of stay and analysing them by the person-years method. The number of observed deaths was compared with the number of deaths expected applying the mortality rate of the general population to the numbers of inpatients of the same sex and age group and this gave us a standardised mortality ratio:SMR. Excess mortality in psychiatric inpatients, still apparent in this population, is decreasing except among women aged under 45, for whom it remains very high. Taking all causes of death combined, the mortality level in 1982 was almost 10 times higher than in the same female age group in the general population. Even when mortality is studied after exclusion of traffic accident deaths, the gap between men and women remained almost the same. The SMR for psychoses and mental retardation should no tendency to decrease in women aged under 55 and the SMR for neuroses showed a regular increase from 1972. A reduction was observed for all diagnostic groups studied in the 55 plus age group, for both men and women.