Epidemiological survey of the "natural" mortality in psychiatry.

The authors reviewed articles published from 1838 dealing with excess of "natural" mortality in psychiatric "in-" and "out" patients. The high natural mortality rate has always existed and is still observed today despite the quality of somatic care. The excess is observed in every country, ethnic group, sex, age or site of treatment but does not seem to be associated with specific organic pathology. The risk of "natural" mortality (suicide and accidents excluded) remains 2 to 5 times greater than in normals. Hypotheses concerning the phenomenon are reviewed or suggested.