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Mortality of long-term psychiatric inpatients. Retrospective study on a cohort of long-term patients in the psychiatric hospital of Bologna, Italy

Published online by Cambridge University Press:  11 October 2011

Angelo Fioritti ,
Daniela Lipparini  and
Vittorio Melega
Angelo Fioritti*
Affiliation:
Servizio di Salute Mentale - USL 27, Bologna Ovest, Bologna
Daniela Lipparini
Affiliation:
Servizio di Salute Mentale - USL 27, Bologna Ovest, Bologna
Vittorio Melega
Affiliation:
Servizio di Salute Mentale - USL 27, Bologna Ovest, Bologna
*
Indirizzo per la corrispondenza: Dr. A. Fioritti, Servizio di Salute Mentale, USL 27, Bologna Ovest, viale Pepoli 5, 40123 Bologna. Fax (+39)051-649.2322.
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Summary

Objective - The present study was conducted to determine the excess of mortality in long-term psychiatric inpatients. Setting - Psychiatric hospital, Bologna, Italy. Design – Retrospective study on a cohort of 264 chronic psychiatric inpatients, followed up for ten years since January 1981. Mortality measures were computed by psychiatric diagnosis, length of stay and «still resident at follow-up/discharged» condition. Main measures – Standardized mortality ratios were computed with reference to the mortality by age of the population resident in Bologna in the years 1981- 1991. Presence in the cohort was expressed in person/years. Results – The excess of deaths in the cohort was 2.89 (CI 95%: 2.12-3.86) for males and 2.38 (CI: 1.66-3.31) for females. A remarkable excess of deaths for both sexes was observed in the class of age 15/44 (18.33 for males, CI 9.14-32.81; 60 for females, CI: 21.91-130.6 ) and in association with a diagnosis of personality disorder/alcohol abuse (11.25 for males, CI: 5.13-21.36; 5 for females, CI: 1.35-12.8). Length of stay and age of patients were inversely associated with SMRs. Conclusion – The present study confirms that the excess of mortality is high in psychiatric long-term inpatients and that it may be concentrated in younger classes of age, first years after admission and in subjects with diagnoses of personality disorder/alcohol abuse.

Riassunto

Scopo - Il presente studio è stato condotto per determinare il rischio di mortalità nei pazienti psichiatrici lungo-degenti. Setting - Ex ospedale psichiatrico provinciale «F. Roncati» di Bologna. Disegno - Studio di coorte retrospettivo con un follow-up di dieci anni in cui si è calcolato il tasso di mortalità complessivo e disaggregato per diagnosi psichiatrica, durata del ricovero e condizione «ricoverato al termine del follow-up/dimesso», dei 264 pazienti degenti presso l'istituto l'1.1.1981. Misure utilizzate - I tassi di mortalità sono stati calcolati e successivamente confrontati utilizzando il Rapporto Standardizzato di Mortalità (Standardized Mortality Ratio - SMR). La standardizzazione per sesso e classi di età è avvenuta prendendo come riferimento la mortalita della popolazione residente a Bologna nel decennio 1981-1991. La presenza nella coorte dei singoli soggetti è stata misurata in anni-persona. Risultati - La condizione di de- gente comporta un eccesso di mortalità di 2.89 per gli uomini (IC 95%: 2.12-3.86) e di 2.38 (IC: 1.66-3.31) per le donne. Si è registrato inoltre un forte eccesso di mortalità per la classe di eta dai 15 ai 44 anni sia per gli uomini (18.33; IC: 9.14-32.81) che per le donne (60; IC: 21.91-130.6) e nei soggetti con diagnosi di caratteropatia/alcolismo (uomini, 11.25; IC: 5.13-21.36; donne, 5; IC: 1.35-12.8). Si è registrata infine una diminuzione dell'eccesso di mortalita al crescere della durata del ricovero e della eta dei pazienti. Conclusioni - Lo studio conferma l'esistenza di un forte rischio di mortalita associato alia condizione di paziente psichiatrico istituzionalizzato, concentrato soprattutto nelle classi d'età piu giovani, nei primi anni di ricovero e nei soggetti con diagnosi di caratteropatia/alcolismo.

Keywords

mortalitarapporto standardizzato di mortalitàpazienti psichiatrici lungodegentimortalitystandardized mortality ratiolong-term psychiatric inpatients
Type
Articles
Information
Epidemiology and Psychiatric Sciences , Volume 3 , Issue 2 , August 1994 , pp. 107 - 114
Copyright
Copyright © Cambridge University Press 1994

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