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Excess Mortality Among Elderly Psychiatric In-Patients with Organic Mental Disorder

Published online by Cambridge University Press:  02 January 2018

W. Rössler*
Affiliation:
Mental Health Services Research Unit
W. Hewer
Affiliation:
Mental Health Services Research Unit
B. Fätkenheuer
Affiliation:
Mental Health Services Research Unit
W. Löffler
Affiliation:
Mental Health Services Research Unit
*
Dr W. Rössler, Mental Health Services Research Unit, Zentralinstitut für Seelische Gesunndheit, Postfach 12 21 20, Mannheim, Germany

Abstract

Background

Many studies have shown hospitalised mentally ill patients to have a higher mortality risk than the general population.

Method

Data of patients with organic mental disorders of ICD–9 categories 290, 293, 294 and 310 from seven psychiatric hospitals with defined catchment areas were analysed. During an observation period of 2.5 years 1821 treatment periods in these diagnostic categories were recorded.

Results

During hospitalisation 137 patients died from natural causes. The age- and sex-adjusted mortality rates show an increased mortality risk of 7.5 times, compared to the general population. The odds ratio of a logistic regression demonstrate the overwhelming influence of the medical diagnosis.

Conclusion

Medical factors, particularly pneumonias, contribute most to the excess mortality.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Abiodun, O. A. (1988) Mortality in a psychiatric population: a Nigerian psychiatric hospital experience. Acta Psychiatrica Scandinavica, 77, 652657.Google Scholar
Ashby, D., Ames, D., West, C. R., et al (1991) Psychiatric morbidity as predictor of mortality for residents of local authority homes for the elderly. International Journal of Geriatric Psychiatry, 6, 567575.Google Scholar
Black, D. & Jolley, D. (1991) Deaths in psychiatric care. International Journal of Geriatric Psychiatry, 6, 489495.Google Scholar
Black, D., Warrack, G. & Winokur, G. (1985a) The Iowa Record-linkage study. II: Excess mortality among patients with organic mental disorder. Archives of General Psychiatry, 42, 7881.Google Scholar
Black, D., Warrack, G. & Winokur, G. (1985b) Excess mortality among psychiatric patients. The Iowa record-linkage study. Journal of the American Medical Association, 253, 5861.Google Scholar
Bonhoeffer, K. (1910) Die symptomatischen Psychosen im Gefolge von akuten Infektionen und inneren Erkrankungen. Leipzig: Deuticke.Google Scholar
Brook, O. H. (1985) Mortality in the long-stay population of Dutch mental hospitals. Acta Psychiatrica Scandinavica, 71, 626635.Google Scholar
Burns, A. (1992) Editorial: Cause of death in dementia. International Journal of Geriatric Psychiatry, 7, 461464.Google Scholar
Casadebaig, F. & Quemada, N. (1989) Mortality in psychiatric inpatients. Acta Psychiatrica Scandinavica, 79, 257264.Google Scholar
Craig, T. J. & Lin, S. P. (1981) Mortality among psychiatric inpatients. Archives of General Psychiatry, 38, 935938.Google Scholar
Francis, J. (1992) Delirium in older patients. Journal of the American Geriatrics Society, 40, 829833.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.Google Scholar
Greer, A., McBride, D. A. & Shenkin, A. (1988) Comparison of the nutritional state of new and long-term patients in a psychiatric unit. British Journal of Psychiatry, 149, 738741.Google Scholar
Häfner, H. & Bickel, H. (1989) Physical morbidity and mortality in psychiatric patients. In Interaction between Mental and Physical Illness (eds Öhmann, R., Freeman, H. L., Franck holmkvist, A., et al), pp. 2947. Berlin: Springer.Google Scholar
Hassall, C., Prior, P. & Cross, K. W. (1988) A preliminary study of excess mortality using a psychiatric case register. Journal of Epidemiology and Community Health, 42, 286289.Google Scholar
Hewer, W., Rössler, W., Fätkenheuer, B., et al (1991a) Mortalität von Patienten mit organisch bedingten psychischen Störungen während des Zeitraums stationärer psychiatrischer Behandlung. Nervenarzt, 62, 170176.Google Scholar
Hewer, W., Rössler, W., Jung, E., et al (1991b) Somatische Erkrankungen bei stationär behandelten psychiatrischen Patienten. Psychiatrische Praxis, 18, 133138.Google Scholar
Hewer, W., Biedert, S., Förstl, H., et al (1992) Unentdeckte körperliche Erkrankungen bei psychiatrischen Neuaufnahmen. Psychiatrische Praxis, 19, 171177.Google Scholar
Hewer, W., Rössler, W., Fätkenheuer, B., et al (1995) Mortality among patients in German psychiatric hospitals. Acta Psychiatrica Scandinavica, 91, 174179.Google Scholar
Jenkins, R. (1992) Health targets. In Measuring Mental Health Needs (eds Thornicroft, G., Brewin, C. R. & Wing, J.). London: Gaskell.Google Scholar
Kalinowsky, L. B., Hippius, H. & Klein, H. E. (1982) Biological Treatments in Psychiatry. New York: Grune & Stratton.Google Scholar
Kane, J. M. & Lieberman, J. A. (1992) Adverse Effects of Psychotropic Drugs. New York: Guilford Press.Google Scholar
Koran, L. M., Sox, H. C., Marton, K. I., et al (1989) Medical evaluation of psychiatric patients. I. Results in a state mental health system. Archives of General Psychiatry, 46, 733740.Google Scholar
Lipowski, Z. J. (1990) Delirium: Acute Confusional States. New York: Oxford University Press.Google Scholar
Martin, R. L., Cloninger, R., Guze, S. G., et al (1985) Mortality in a follow-up of 500 psychiatric outpatients. I. Total mortality. Archives of General Psychiatry, 42, 4754.Google Scholar
Martin, R. L., Miller, J. K., Kapoor, W., et al (1987) A controlled study of survival in dementia. Archives of Neurology, 44, 11221126.Google Scholar
Mölsä, P. K., Martilla, R. J. & Rinne, U. K. (1984) Mortality of patients with dementia. Acta Neurologica Scandinavica (suppl. 98), 69, 230231.Google Scholar
Mortensen, P. B. & Juel, K. (1993) Mortality and causes of death in first admitted schizophrenic patients. British Journal of Psychiatry, 163, 183189.Google Scholar
Pearson, E. S. & Hartley, H. O. (1976) Biometrika Tables for Statisticians. Vol I. London: Biometrika Trust.Google Scholar
Rabins, P. V. & Folstein, M. F. (1982) Delirium and dementia: diagnostic criteria and fatality rates. British Journal of Psychiatry, 140, 149153.Google Scholar
Robinson, J. R. (1989) The natural history of mental disorder in old age. British Journal of Psychiatry, 154, 783789.Google Scholar
Rössler, W., Häfner, H., an der Heiden, W., et al (1985) Außerstationäre psychiatrische Versorgung. Weinheim: Beltz.Google Scholar
Rössler, W., Häfner, H., Martini, H., et al (1987) Landesprogramm zur Weiterentwicklung der außerstationären psychiatrischen Versorgung Baden-Württemberg – Analysen, Konzepte, Erfahrungen. Weinheim: Deutscher Studien Verlag.Google Scholar
Roy, A. (1982) Suicide in chronic schizophrenia. British Journal of Psychiatry, 141, 171177.Google Scholar
Ryan, D. H. (1992) Hospital survival time in dementia: a controlled study of the effect of marital status on the interval between first admission and death. International Journal of Geriatric Psychiatry, 7, 389397.Google Scholar
Saugstad, L. F. & Ödegard, O. (1979) Mortality in psychiatric hospitals in Norway. 1950–1974. Acta Psychiatrica Scandinavica, 59, 431447.Google Scholar
Schabö, W. & Uehlingen, H. M. (1986) SPSS-X, Handbuch der programmversion 2.2. Stuttgart: Fischer.Google Scholar
Schwalb, H., Schimana, W., Brüninghaus, H., et al (1987) Mortalität hospitalisierter psychiatrischer Patienten – Ergebnisse einer 10-Jahresstudie. Fortschritte der Neurologie und Psychiatrie, 55, 8390.Google Scholar
Sims, A. C. P. (1982) Mortality in psychiatric patients. In Physical Illness in the Psychiatric Patient (ed. Koranyi, E. K.), pp. 2441. Springfield, IL: Thomas.Google Scholar
Statistisches Bundesamt (1986) Statistisches Jahrbuch 1986 für die Bundesrepublik Deutschland. Bonn: Statistisches Bundesamt.Google Scholar
Tsuang, M. T. & Fleming, J. A. (1980) Causes of death in schizophrenia and manic-depression. British Journal of Psychiatry, 136, 239242.Google Scholar
Wing, J., Brewin, C. R. & Thornicroft, G. (1992) Defining mental health needs. In Measuring Mental Health Needs (eds Thornicroft, G., Brewin, C. R. & Wing, J.). London: Gaskell.Google Scholar
Wood, J. B., Everson, R. C., Cho, D. W., et al (1985) Mortality variations among public health mental patients. Acta Psychiatrica Scandinavica, 72, 218229.Google Scholar
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