Mortality in the long-stay population of Dutch mental hospitals.

The cohort study by Giel et al. of mortality in Dutch mental hospitals is repeated. In the total cohort of 12,139 long-stay patients counted on prevalence day (31 December 1979) 1226 deaths occurred over a period of 2 years. Similar to the study of Giel et al. the overall death rate of long-stay patients in the 1979 cohort was approximately twice the expected death rates in the general population. The death rate of patients of both sexes and in each age group significantly exceeded the expected. In our study we found a different pattern of somatic causes of death. In the 1969 cohort respiratory disease was a major cause of death. In our long-stay cohort respiratory disease was a minor cause of death in all age groups. Another difference is the replacement of cardiovascular disease as a main cause of death by diseases of the cerebrovascular system.