Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-06T13:05:16.310Z Has data issue: false hasContentIssue false

La mortalità e le cause di morte fra i pazienti psichiatrici

Published online by Cambridge University Press:  07 August 2014

Eugenio Aguglia*
Affiliation:
Istituto di Clinica Psichiatrica, Università di Trieste, Trieste
Roberto Pagnanelli
Affiliation:
Istituto di Clinica Psichiatrica, Università di Trieste, Trieste
Marco Clocchiatti
Affiliation:
Istituto di Clinica Psichiatrica, Università di Trieste, Trieste
Maurizio de Vanna
Affiliation:
Istituto di Clinica Psichiatrica, Università di Trieste, Trieste
*
Indirizzo per la corrispondenza: Professor E. Aguglia, Istituto di Clinica Psichiatrica, Universita di Trieste, via S. Cilino 16, 34100 Trieste. Fax (+ 39) 040-566.179.

Summary

Objective - Gathering, comparing and, if possible, commenting on datas and experimental evidences which have emerged in the principal literary works about mortality and psychiatric patients' causes of death. Particularly finding an answer (and a possible explanation) to some of the most important questions about these matters: does a psychiatric patient die easier than a healthy man? Does a correlation exist between nosographic diagnosis and causes of death? Finally do factors of risk, which are connected with death, exist? Method - The principal bibliographies which exist in national and international literature, from the middle of the last century until present days, have been consulted. Results - Essential agreement among existing dates in literature have emerged. Psychiatric patients dies easier than healthy man: rates of mortality have fallen from 6-7 (SMR), value of the middle of 1800 to 1,5-3 which is the value of present days. Respiratory, cardiovascular and, still, infectious diseases are the most important causes of death. There is not agreement about deaths caused by cancer. Some researchers affirm the protective action of psychiatric disease against the rising and diffusion of cancer. Non natural deaths (in primis suicide and accidental deaths) are rapresented too. All diagnostic categories (from alcholism to homosexuality, from organic brain disorders to schizophrenia) have a high risk of death while affective disorders have to be studied further. Young people have the highest risk. Conclusions - The frequency of physical beside psychic disease suggests to pay more attention to patient's general conditions even by some diagnostic ascertainments (TAC, RMN, etc) which are able to identify the most disabling conditions for the prognosis (diabetes, arterial hypertension, organic cerebral syndromes, etc).

Type
Articoli
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Abiodun, O.A. (1988). Mortality in a psychiatric population: a nigerian psychiatric hospital experience. Acta Psychiatrica Scandinavia! 77, 654657.CrossRefGoogle Scholar
Akiskal, H., Bitar, A.N., Puzantoin, V.R., Rosenthal, T.L. & Walker, P. (1978). The nosological status of neurotic depression: a prospective three to four year follow-up examination in light of the primary-secondary and unipolar dichotomies. Archives of General Psychiatry 35, 756766.CrossRefGoogle ScholarPubMed
Allebeck, P. & Wisted, B. (1986). Mortality in schizophrenia. Archives of General Psychiatry 43, 650653.CrossRefGoogle ScholarPubMed
Allebeck, P., Varia, A., Kristjansson, E. & Wistedt, B. (1987). Risk factors for suicide among patients with schizophrenia. Acta Psychiatrica Scandinavica 76, 414419.CrossRefGoogle ScholarPubMed
Avery, D. & Winokur, G. (1976). Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. Archives of General Psychiatry 33, 10291037.CrossRefGoogle ScholarPubMed
Babigian, H.F. & Odoroff, C.L. (1969). The mortality experience of a population with psychiatric illness. The American Journal of Psychiatry 126, 470480.CrossRefGoogle ScholarPubMed
Bacigalupi, M., Cecere, F., Arcà, M., Perucci, C.A. & Morosini, P. (1988), La mortalità dei pazienti ricoverati negli ospedali psichiatrici pubblici della Regione Lazio: primi risultati. Epidemiologia e Prevenzione 35, 1116.Google Scholar
Ballone, E., Contini, G. & Di Mascio, R. (1991). La mortalità dei dimessi dall'Ospedale Psichiatrico. Rivista Sperimentale di Freniatria 115, 2, 211218.Google Scholar
Barraclough, B.M., Bunch, J., Nelson, B. & Sainsbury, P. (1974). A hundred case of suicide: clinical aspects. British Journal of Psychiatry 125, 355378.CrossRefGoogle Scholar
Black, D.W. & Fisher, R. (1992). Mortality in DSM-III-R schizophrenia. Schizophrenia Research 7(2), 109116.CrossRefGoogle Scholar
Black, D.W., Warrach, G. & Winokur, G. (1985a). Excess mortality among psychiatric patients - the Iowa record-linkage study. Journal of American Medical Association 253, 5861.CrossRefGoogle Scholar
Black, D.W., Warrach, G. & Winokur, G. (1985b). The Iowa record-linkage study. Part I - II. Archives of General Psychiatry 42, 71-75; 7881.CrossRefGoogle Scholar
Boyd, J.H. (1983). The increasing rate of suicide by firearms. The New England Journal of Medicine 308, 872874.CrossRefGoogle ScholarPubMed
Brook, O.H. (1985). Mortality in the long-stay population of dutch mental hospitals. Acta Psychiatrica Scandinavica 71, 622635.CrossRefGoogle ScholarPubMed
Buda, M., Tsuang, M.T. & Fleming, J.A. (1988). Causes of death in DSM-III schizophrenics and other psychotics (atipical group). Archives of General Psychiatry 45, 283285.CrossRefGoogle Scholar
Buzan, R.D. & Weissberg, M.P. (1992). Suicide: risk factors and prevention in medical practice. Annual Review of Medicine 43, 3746.CrossRefGoogle ScholarPubMed
Casadebaig, F. & Quemada, N. (1989). Mortality in psychiatric inpatients. Acta Psichiatrica Scandinavica 79, 257264.CrossRefGoogle ScholarPubMed
Casadebaig, F. & Quemada, N. (1991). Changes in mortality among psychiatric inpatients, 1962-1982. Social Psychiatry and Psychiatric Epidemiology 26, 7882.CrossRefGoogle Scholar
Claghorn, J.L. & Kinross-Wright, J. (1967). Death rates in psychiatric outpatients. Journal of Nervous and Mental Disease 145, 163167.CrossRefGoogle ScholarPubMed
Comroe, B.I. (1936). Journal of Nervous and Mental Disease 83, 679.CrossRefGoogle Scholar
Craig, T.J. & Lin, S.P. (1981). Mortality among psychiatric inpatients. Archives of General Psychiatry 38, 935938.CrossRefGoogle ScholarPubMed
Culpan, R.H., Davies, B.M. & Oppenheim, A.N. (1960). Incidence of psychiatric illness among hospital outpatients. British Medical Journal 1, 855.CrossRefGoogle Scholar
Dan, B., Gregoire, F., Verbanck, P., Corten, P. & Pelc, I. (1991). Organic morbidity of a hospitalized psychiatric population. Acta Clinica Belgica 46(4), 209218.CrossRefGoogle ScholarPubMed
Dupont, A.Moller Jensen, O., Stromgren, E. & Jablensky, A. (1986). Incidence of cancer in patients diagnosed as schizophrenic in Denmark. In Psychiatric Case Registers in Public Health (ed. Horn, GHMM Ten), pp. 229239. Elsevier: Amsterdam.Google Scholar
Esquirol, E. (1838). Des maladies mentales. Bailliere: Paris.Google Scholar
Farr, W. (1841). Report upon the mortality of lunatics. Journal of the Statistical Society 4, 1733.Google Scholar
Gausset, M.F., Casadebaig, F., Guillaud-Bataille, J.M., Quemada, N. & Terra, J.L. (1992). Mortality of mentally ill patients. Review of the literature. Encephale 18(1), 93100.Google ScholarPubMed
Giannichedda, M.G. (1986). Preliminary report of Trieste for the WHO regional bureau for Europes pilot study in mental health areas. Trieste.Google Scholar
Giel, R., Dijk, S. & Van Weerden-Dijkstra, J.R. (1978). Mortality in the long-stay population of all Dutch mental hospitals. Acta Psychiatrica Scandinavica 57, 361368.CrossRefGoogle ScholarPubMed
Herridge, C.F. (1960). Physical disorders in psychiatric illness. The Lancet!, 949951.CrossRefGoogle ScholarPubMed
Hoenig, J. & Hamilton, M.W. (1966). Mortality of psychiatric patients. Acta Psychiatrica Scandinavica 42, 349361.CrossRefGoogle ScholarPubMed
Holding, T.A. & Barraclough, B.M. (1977). Psychiatric morbidity in a sample of accidents. British Journal of Psychiatry 130, 244252.CrossRefGoogle Scholar
Honig, A., Pop, P., Tan, E.S., Philipsen, H. & Romme, M.A.J. (1989). Physical illness in chronic psychiatric patients from a community psychiatric unit. British Journal of Psychiatry 155, 5864.CrossRefGoogle ScholarPubMed
Hussar, A.E. (1966). Leading causes of death in istitutionalized chronic schizophrenic patients: a study of 1275 autopsy protocols. The Journal of Nervous and Mental Disease 142, 4555.CrossRefGoogle Scholar
Innes, G. & Millar, W.M. (1970). Mortality among psychiatric patients. Scottish Medical Journal 15, 143148.CrossRefGoogle ScholarPubMed
Jørgensen, P. & Mortensen, P.B. (1990). Reactive psychosis and mortality. Acta Psychiatrica Scandinavica 81, 277279.CrossRefGoogle ScholarPubMed
Kendler, K.L. (1986). A twin study of mortality in schizophrenia and neuroses. Archives of General Psychiatry 43, 643649.CrossRefGoogle Scholar
Koranyi, E.K. (1977). Fatalities in 2070 psychiatric out-patients. Archives of General Psychiatry 34, 11371142.CrossRefGoogle Scholar
Kuperman, S., Black, D.W. & Burns, T.L. (1988). Excess mortality among formerly hospitalized child psychiatric patients. Archives of General Psychiatry 45, 277282.CrossRefGoogle ScholarPubMed
Lesage, A.D., Trapani, V. & Tansella, M. (1990). Excess mortality by natural causes of Italian schizophrenic patients. European Archives of Psychiatry and Neurological Sciences 239, 361365.CrossRefGoogle ScholarPubMed
Lingjerde, O. (1950). Schizofreni som adaptasjonssyndrom (schizophrenia as an adaptation syndrome). Nordisk Medicine 44.Google Scholar
Malzberg, B. (1934). Mortality among Patients with Mental Disease. State Hospital Press: Utica, NT.Google Scholar
Martin, R., Cloninger, C.R., Guze, S.B. & Clayton, P.J. (1985). Mortality in a follow-up of 500 psychiatric outpatients. I. Total mortality. II. Cause specific mortality. Archives of General Psychiatry 42, 47-54; 5866.CrossRefGoogle Scholar
Masterson, E. & O'Shea, B. (1984). Smoking and malignancy in schizophrenia. British Journal of Psychiatry 145, 429432.CrossRefGoogle ScholarPubMed
Miles, C.P. (1977). Conditions predisposing to suicide: a review. Journal of Nervous and Mental Disease 164, 231246.CrossRefGoogle ScholarPubMed
Morrison, J.R. (1982). Suicide in psychiatric practice population. Journal of Clinical Psychiatry 43, 348352.Google ScholarPubMed
Nemiah, J.C. & Sifneos, P.E. (1970). Affect and fantasy in patients with psychosomatic disorders. In Modern Trends in Psychosomatic Medicine (ed. Hill, O.W.), pp. 2634. Butter-worths: London.Google Scholar
Ødegaard, Ø. (1952). The excess mortality of the insane. Acta Psychiatrica and Neurologica Scandinavica 27, 353367.CrossRefGoogle Scholar
Paffenbarger, R.S., King, S.H. & Wing, A.L. (1969). Chronic disease in former college students. The American Journal of Public Health 59, 900908.CrossRefGoogle ScholarPubMed
Perris, C. & D'Elia, G. (1966). A study of bipolar (manic depressive) and unipolar recurrent depressive psychoses. Acta Psychiatrica Scandinavica 42, Supplementum No 194, 172183.Google Scholar
Rahe, R.H., Romo, M., Bennett, L. & Siltanen, P. (1974). Recent life changes, myocardial infarction and abrupt coronary death. Archives of Internal Medicine 133, 221.CrossRefGoogle ScholarPubMed
Rorsman, B. (1968). Dodligheten bland psykiatriska patienter. Laakartidn 65, 149156.Google Scholar
Rorsman, B. (1974). Mortality among psychiatric patients. Acta Psychiatrica Scandinavica 50, 354375.CrossRefGoogle ScholarPubMed
Rorsman, B., Hagnell, O. & Lanke, J. (1983). Mortality and hidden mental disorder in the Lundby study. Neuropsychobiology 10, 8389.CrossRefGoogle ScholarPubMed
Saugstad, L.F. & Ødegaard, Ø. (1979). Mortality in psychiatric hospital in Norway 1950-1974. Acta Psychiatrica Scandinavica 59, 431447.Google Scholar
Schmale, A.H. & Iker, H.P. (1966). The affect of hopelessness and the development of cancer. Psychosomatic Medicine 28, 714721.CrossRefGoogle Scholar
Segal, S.P. & Kotler, P.L. (1991). A ten-year perspective of mortality risk among mentally ill patients in sheltered care. Hospital Community Psychiatry 7, 708713.Google Scholar
Shepherd, M. (1957). A study of a major psychoses in an English county. Maudsley Monographs.Google Scholar
Sims, A. (1978). Hypothesis linking neuroses with premature mortality. Psychologies Medical 8, 255–63.CrossRefGoogle Scholar
Sims, A. & Prior, P. (1978). The pattern of mortality in severe neurosis. British Journal of Psychiatry 133, 299305.CrossRefGoogle Scholar
Sims, A. (1870). Why the excess mortality from psychiatric illness? British Medical Journal 294, 986987.CrossRefGoogle Scholar
Tefft, B.M., Pederson, A.M. & Babigian, H.F. (1977). Patterns of death among suicide attempters, a psychiatric population and a general population. Archives of General Psychiatry 34, 11551162.CrossRefGoogle ScholarPubMed
Temoche, A., Pugh, T.F. & Macmahon, B. (1964). Suicide rates among current and former mental institution patients. Journal of Nervous and Mental Disease 138, 124130.CrossRefGoogle ScholarPubMed
Tsuang, M.T. (1978). Suicide in schizophrenics, manics, depressive and surgical controls. A comparison with general population suicide mortality. Archives of General Psychiatry 35, 153–55.CrossRefGoogle ScholarPubMed
Tsuang, M.T. & Woolson, R.F. (1977). Mortality in patients with schizophrenia, mania, depression and surgical conditions. British Journal of Psychiatry 130, 162166.CrossRefGoogle ScholarPubMed
Tsuang, M.T. & Simpson, J.C. (1985). Mortality studies in psychiatry. Archives of General Psychiatry 42, 98103.CrossRefGoogle ScholarPubMed
Tsuang, M.T., Woolson, R.F. & Fleming, J.A. (1979). Long-term outcome of major psychoses. Archives of General Psychiatry 36, 12951301.CrossRefGoogle ScholarPubMed
Tsuang, M.T., Woolson, R.F. & Fleming, J.A. (1980). Causes of death in schizophrenia and manic-depression. British Journal of Psychiatry 136, 239242.CrossRefGoogle ScholarPubMed
Whitlock, F.A. & Siskind, M. (1979). Depression and cancer - a follow-up study. Psychological Medicine 9, 747752.CrossRefGoogle ScholarPubMed
Winokur, G. & Black, D.W. (1987). Psychiatric and medical diagnoses as risk factor for mortality in psychiatric patients: a case-control study. American Journal of Psychiatry 144, 208211.Google ScholarPubMed
Wood, J.B., Evenson, R.C., Cho, D.W. & Kagan, B.J. (1985). Mortality variations among public mental health patients. Acta Psychiatrica Scandinavica 72, 218229.CrossRefGoogle ScholarPubMed
World Health Organization (1980). International Classification of Diseases, 9th Revision, ed. 2. vol. 1. Dept. of Health and Human Services.Google Scholar
Zilber, N.Schufman, N. & Lerner, Y. (1989). Mortality among psychiatric patients - the group at risk. Acta Psychiatrica Scandinavica 79, 248256.CrossRefGoogle Scholar