Mortality of Finnish Acute Psychiatric Hospital Patients

Overview

Journal Soc Psychiatry Psychiatr Epidemiol

Specialties Psychiatry
Public Health
Social Sciences

Date 2008 May 15

PMID 18478169

Citations 8

Authors

Heidi Honkonen

Aino K Mattila

Klaus Lehtinen

Teemu Elo

Riina Haataja

Matti Joukamaa

Affiliations

Soon will be listed here.

Abstract

Objective: The mortality of psychiatric patients is higher than that of the general population. Earlier studies have typically focused on specific diagnostic categories or causes of death. The aim of this study was to assess the overall mortality in acute psychiatric hospital patients covering all diagnostic groups, with special emphasis on substance abuse.

Methods: The sample consisted of all 18-64-year old patients (n = 3,835) treated or evaluated in the acute wards of the Department of Psychiatry at Tampere University Hospital between the years 1999 and 2003, who were followed-up until the end of the year 2005. We assessed the various causes of death according to background variables in bivariate and multivariate analyses and calculated the standardized mortality ratios (SMRs).

Results: During the study period 379 subjects died (9.9% of the sample). Mortality among men was almost twice as high as among women. Of all deaths, 45.6% were considered to be alcohol or drug related. SMR covering all subjects was 6.55. The SMRs for unnatural causes were higher than those for natural causes. The highest SMRs for unnatural causes of death were found in patients with mood disorders and the highest SMRs for natural causes of death in patients with schizophrenia spectrum disorders. Use of coercive measures was associated with increased mortality.

Conclusion: Mortality among Finnish psychiatric acute hospital patients is considerably higher than in general population. Excessive alcohol consumption plays a major role in causing excess deaths that could be potentially avoided.

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References

Tidemalm D, Elofsson S, Stefansson C, Waern M, Runeson B . Predictors of suicide in a community-based cohort of individuals with severe mental disorder. Soc Psychiatry Psychiatr Epidemiol. 2005; 40(8):595-600. DOI: 10.1007/s00127-005-0941-y. View

Honkonen T, Karlsson H, Koivisto A, Stengard E, Salokangas R . Schizophrenic patients in different treatment settings during the era of deinstitutionalization: three-year follow-up of three discharge cohorts in Finland. Aust N Z J Psychiatry. 2003; 37(2):160-8. DOI: 10.1046/j.1440-1614.2003.01137.x. View

Heila H, Isometsa E, Henriksson M, Heikkinen M, Marttunen M, Lonnqvist J . Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. Am J Psychiatry. 1997; 154(9):1235-42. DOI: 10.1176/ajp.154.9.1235. View

Pirkola S, Sohlman B, Heila H, Wahlbeck K . Reductions in postdischarge suicide after deinstitutionalization and decentralization: a nationwide register study in Finland. Psychiatr Serv. 2007; 58(2):221-6. DOI: 10.1176/ps.2007.58.2.221. View

Meloni D, Miccinesi G, Bencini A, Conte M, Crocetti E, Zappa M . Mortality among discharged psychiatric patients in Florence, Italy. Psychiatr Serv. 2006; 57(10):1474-81. DOI: 10.1176/ps.2006.57.10.1474. View

Crisanti A, Love E . Mortality among involuntarily admitted psychiatric patients: a survival analysis. Soc Psychiatry Psychiatr Epidemiol. 2000; 34(12):627-33. DOI: 10.1007/s001270050185. View

Hewer W, Rossler W, Fatkenheuer B, Loffler W . Mortality among patients in psychiatric hospitals in Germany. Acta Psychiatr Scand. 1995; 91(3):174-9. DOI: 10.1111/j.1600-0447.1995.tb09762.x. View

Joukamaa M, Heliovaara M, Knekt P, Aromaa A, Raitasalo R, Lehtinen V . Mental disorders and cause-specific mortality. Br J Psychiatry. 2001; 179:498-502. DOI: 10.1192/bjp.179.6.498. View

Makela P, Valkonen T, Martelin T . Contribution of deaths related to alcohol use to socioeconomic variation in mortality: register based follow up study. BMJ. 1997; 315(7102):211-6. PMC: 2127147. DOI: 10.1136/bmj.315.7102.211. View

10.

Lawrence D, Jablensky A, Holman C, Pinder T . Mortality in Western Australian psychiatric patients. Soc Psychiatry Psychiatr Epidemiol. 2000; 35(8):341-7. DOI: 10.1007/s001270050248. View

11.

Kaltiala-Heino R, Korkeila J, Tuohimaki C, Tuori T, Lehtinen V . Coercion and restrictions in psychiatric inpatient treatment. Eur Psychiatry. 2000; 15(3):213-9. DOI: 10.1016/s0924-9338(00)00223-6. View

12.

Schneider B, Muller M, Philipp M . Mortality in affective disorders. J Affect Disord. 2001; 65(3):263-74. DOI: 10.1016/s0165-0327(00)00290-1. View

13.

Suominen K, Isometsa E, Haukka J, Lonnqvist J . Substance use and male gender as risk factors for deaths and suicide--a 5-year follow-up study after deliberate self-harm. Soc Psychiatry Psychiatr Epidemiol. 2005; 39(9):720-4. DOI: 10.1007/s00127-004-0796-7. View

14.

Ringback Weitoft G, Gullberg A, Rosen M . Avoidable mortality among psychiatric patients. Soc Psychiatry Psychiatr Epidemiol. 1998; 33(9):430-7. DOI: 10.1007/s001270050076. View

15.

Sohlman B, Lehtinen V . Mortality among discharged psychiatric patients in Finland. Acta Psychiatr Scand. 1999; 99(2):102-9. DOI: 10.1111/j.1600-0447.1999.tb07207.x. View

16.

Korkeila J, Tuohimaki C, Kaltiala-Heino R, Lehtinen V, Joukamaa M . Predicting use of coercive measures in Finland. Nord J Psychiatry. 2002; 56(5):339-45. DOI: 10.1080/080394802760322105. View

17.

Salokangas R, Honkonen T, Stengard E, Koivisto A . Mortality in chronic schizophrenia during decreasing number of psychiatric beds in Finland. Schizophr Res. 2002; 54(3):265-75. DOI: 10.1016/s0920-9964(01)00281-x. View

18.

Hitosugi M . Retrospective analysis of the forensic autopsy cases of psychiatric patients. Med Sci Law. 1999; 39(4):293-301. DOI: 10.1177/002580249903900405. View

19.

Lahti R, Penttila A . Cause-of-death query in validation of death certification by expert panel; effects on mortality statistics in Finland, 1995. Forensic Sci Int. 2003; 131(2-3):113-24. DOI: 10.1016/s0379-0738(02)00418-8. View

20.

Brown S . Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry. 1998; 171:502-8. DOI: 10.1192/bjp.171.6.502. View