Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T04:25:55.327Z Has data issue: false hasContentIssue false
  • English
  • Français

Hospital-treated physical illnesses and mortality: An 11-year follow-up study of long-stay psychiatric patients

Published online by Cambridge University Press:  16 April 2020

Sami Räsänen ,
Victor Benno Meyer-Rochow ,
Juha Moring  and
Helinä Hakko
Sami Räsänen
Affiliation:
Department of Psychiatry, Oulu University Hospital, PO Box 26, 90029Oulu, Finland
Victor Benno Meyer-Rochow
Affiliation:
International University Bremen IUB, Faculty of Engineering & Science, PO Box 750 561, 28725Bremen, Germany
Juha Moring
Affiliation:
Department of Psychiatry, Oulu University Hospital, PO Box 26, 90029Oulu, Finland
Helinä Hakko*
Affiliation:
Department of Psychiatry, Oulu University Hospital, PO Box 26, 90029Oulu, Finland
*
*Corresponding author. Tel.: +358 8 3152011; fax: +358 8 336169. E-mail address:[email protected] (H. Hakko).
Get access

Abstract

Under-recognitions of somatic illnesses have frequently been suggested to explain the well-known increased risks of mortality in long-stay psychiatric patients. There are, however, no studies, in which register information on realized somatic hospitalisations and mortality from somatic illnesses in psychiatric patients are actually linked and simultaneously evaluated. In this study, 208 long-stay psychiatric patients, suffering from functional psychoses (mainly schizophrenia) in Northern Finland were followed up for 11 years, and screened for all somatic hospitalisations and subsequent causes of death. 86.5% of the patients had undergone hospital treatment due to some physical illness after their first psychiatric admission. During specialized psychiatric care the majority of the deceased patients had received some somatic treatment for illnesses that ultimately caused their deaths: 81% representing circulatory, 71% digestive, 56% neoplastic, and 36% respiratory ailments. We found no evidence for the frequently expressed view that somatic illnesses in psychiatric patients were under-recognized. Thus, the widely-documented poor physical outcome of long-stay psychiatric patients may be not attributable to neglect of care or abandon, but to difficulties in efficaciously addressing medical conditions in a population characterised by unhealthy life-style habits, psychiatric disability and isolation. The health care systems apparently offer a range of services, but the latter do not always reach the patients. Why this is so requires detailed further investigation.

Keywords

Schizophrenia and psychosesEpidemiology
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 4 , May 2007 , pp. 211 - 218
Copyright
Copyright © Elsevier Masson SAS 2007

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.)

Footnotes

1

Tel.: +49 421 2003242; fax: +49 421 2003249.

References

Brown, S.Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry 1997;171:502–508.CrossRefGoogle ScholarPubMed
Brown, S.Birtwistle, J.Roe, L.Thompson, C.The unhealthy lifestyle of people with schizophrenia. Psychol Med 1999;29:697–701.CrossRefGoogle ScholarPubMed
Casadebaig, F.Philippe, A.Guillaud-Bataille, M.F.Gausset, N.Quemada, N.Terra, J.L.Schizophrenic patients: physical health and access to somatic care. Eur Psychiatry 1997;12:289–293.CrossRefGoogle ScholarPubMed
D'Avanzo, B.La Vecchia, C.Negri, E.Mortality in long-stay patients from psychiatric hospitals in Italy. Results from the Qualyop Project. SPPE 2003;38:385–389.Google ScholarPubMed
Dalmau, A.Bergman, B.Brismar, B.Somatic morbidity in schizophrenia – a case control study. Public Health 1997;111:393–397.CrossRefGoogle ScholarPubMed
Dixon, L.Postrado, L.Delahanty, J.Fischer, P.J.Lehman, A.The association of medical comorbidity in schizophrenia with poor physical and mental health. J Nerv Ment Dis 1999;187:496–502.CrossRefGoogle ScholarPubMed
Donnelly, M.McGilloway, S.Mays, N.Perry, S.Lavery, C.A 3- to 6-year follow-up of former long-stay psychiatric patients in Northern Ireland. Soc Psychiatry Psychiatr Epidemiol 1997;32:451–458.Google ScholarPubMed
Druss, B.G.Bradford, W.D.Rosenheck, R.A.Radford, M.J.Krumholz, H.M.Quality of medical care and excess mortality in older patients with mental disorders. Arch Gen Psychiatry 2001;58:565–575.CrossRefGoogle ScholarPubMed
Enger, C.Weatherby, L.Reynolds, R.F.Glasser, D.B.Walker, A.M.Serious cardiovascular events and mortality among patients with schizophrenia. J Nerv Ment Dis 2004;192:19–27.CrossRefGoogle ScholarPubMed
Felker, B.Yazel, J.J.Short, D.Mortality and medical comorbidity among psychiatric patients: a review. Psychiatr Serv 1996;47:1356–1363.Google ScholarPubMed
Goldman, L.S.Medical illness in patients with schizophrenia. J Clin Psychiatry 1999;60:10–15.Google ScholarPubMed
Harris, E.C.Barraclough, B.Excess mortality of mental disorder. Br J Psychiatry 1998;173:11–53.CrossRefGoogle ScholarPubMed
Harris, E.C.Barraclough, B.Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997;170:205–228.CrossRefGoogle ScholarPubMed
Jeste, D.V.Gladsjo, J.A.Lindamer, L.A.Lacro, J.P.Medical comorbidity in schizophrenia. Schizophr Bull 1996;22 4:413–430.CrossRefGoogle Scholar
Jones, D.R.Macias, C.Barreira, P.J.Fisher, W.H.Hargreaves, W.A.Harding, C.M.Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness. Psychiatr Serv 2004;55:1250–1257.CrossRefGoogle ScholarPubMed
Joukamaa, M.Heliövaara, M.Knekt, P.Aromaa, A.Raitasalo, R.Lehtinen, V.Mental disorders and cause-specific mortality. Br J Psychiatry 2001;179:498–502.CrossRefGoogle ScholarPubMed
Keskimäki, I.Aro, S.The accuracy of data on diagnoses, procedures and accidents in the Finnish Hospital Discharge Register. Int J Health Sci 1991;2:15–21.Google Scholar
Koran, L.M.Sheline, Y.Imai, K.Kelsey, T.G.Freedland, K.E.Mathews, J.et al.Medical disorders among patients admitted to a public-sector psychiatric inpatient unit. Psychiatr Serv 2002;53:1623–1625.CrossRefGoogle ScholarPubMed
Lahti, R.A.Penttilä, A.The validity of death certificates: routine validation of death certification and its effects on mortality statistics. Forensic Sci Int 2001;115:15–32.CrossRefGoogle ScholarPubMed
Lawrence, D.Homan, C.D.Jablensky, A.V.Threlfall, T.J.Fuller, S.A.Excess cancer mortality in Western Australian psychiatric patients due to higher case fatality rages. Acta Psychiatrd Scand 2000;101:382–388.CrossRefGoogle Scholar
Lamb, H.R.Lessons learned from deinstitutionalization in the US. Br J Psychiatry 1993;162:587–592.CrossRefGoogle ScholarPubMed
Munk-Jorgensen, P.Mors, O.Mortensen, P.B.Ewald, H.The schizophrenic patient in the somatic hospital. Acta Psychiatr Scand 2002;102:96–99.CrossRefGoogle Scholar
Räsänen, S.Hakko, H.Herva, A.Isohanni, M.Nieminen, P.Moring, J.Gender differences in long-stay psychiatric inpatients. Observations from northern Finland. Int J Mental Health 1999;28:69–85.CrossRefGoogle Scholar
Räsänen, S.Hakko, H.Viilo, K.Meyer-Rochow, V.B.Moring, J.Excess mortality among long-stay psychiatric patients in Northern Finland. Soc Psychiatry Psychiatr Epidemiol 2003;38:297–304.CrossRefGoogle ScholarPubMed
Räsänen, S.Hakko, H.Viilo, K.Meyer-Rochow, V.B.Moring, J.Avoidable mortality in long-stay psychiatric patients of Northern Finland. Nord J Psychiatry 2005;59:103–108.CrossRefGoogle ScholarPubMed
Ruschena, D.Mullen, P.E.Burgess, P.Cordner, S.M.Barry-Walsh, J.Drummer, O.H.et al.Sudden death in psychiatric patients. Br J Psychiatry 1998;172:331–336.CrossRefGoogle ScholarPubMed
Sohlman, B.Lehtinen, V.Mortality among discharged psychiatric patients in Finland. Acta Psychiatr Scand 1999;99:102–109.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.