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Mortality of Finnish acute psychiatric hospital patients

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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

  1. Amaddeo F, Bisoffi G, Bonizzato P, Micciolo R, Tansella M (1995) Mortality among patients with psychiatric illness: a ten-year case register study in an area with a community-based system of care. Br J Psychiatry 166:783–788

    PubMed  CAS  Google Scholar 

  2. Bayard-Burfield L, Sundquist J, Johansson S (1998) Self- reported long-standing psychiatric illness as a predictor of premature all-cause mortality and violent death: a 14-year follow-up of native Swedes and foreign-born migrants. Soc Psychiatry Psychiatr Epidemiol 33:491–496

    Article  PubMed  CAS  Google Scholar 

  3. Brown S (1997) Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry 171:502–506

    PubMed  CAS  Google Scholar 

  4. Crisanti AS, Love EJ (1999) Mortality among involuntary admitted psychiatric patients: a survival analysis. Soc Psychiatry Psychiatr Epidemiol 34:627–633

    Article  PubMed  CAS  Google Scholar 

  5. D’Avanzo B, La Vecchia C, Negri E (2003) Mortality in long-stay patients from psychiatric hospitals in Italy. Soc Psychiatry Psychiatr Epidemiol 38:385–389

    PubMed  Google Scholar 

  6. Hansen V, Jacobsen BK, Arnesen E (2001) Cause-specific mortality in psychiatric patients after deinstitutionalisation. Br J Psychiatry 179:438–443

    Article  PubMed  CAS  Google Scholar 

  7. Harris E, Barraclough B (1998) Excess mortality of mental disorder. Br J Psychiatry 173:11–53

    PubMed  CAS  Google Scholar 

  8. Heilä H, Haukka J, Suvisaari J, Lönnqvist J (2005) Mortality among patients with schizophrenia and reduced psychiatric hospital care. Psychol Med 35:725–732

    Article  PubMed  Google Scholar 

  9. Heilä H, Isometsä ET, Henriksson MM, Heikkinen ME, Marttunen MJ, Lönnqvist JK (1997) Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. Am J Psychiatry 154:1235–1242

    PubMed  Google Scholar 

  10. Hewer W, Rössler W, Fätkenheuer B, Löffler W (1995) Mortality among patients in psychiatric hospitals in Germany. Acta Psychiatr Scand 91:174–179

    Article  PubMed  CAS  Google Scholar 

  11. Hitosugi M (1999) Retrospective analysis of the forensic autopsy cases of psychiatric patients. Med Sci Law 39:293–301

    PubMed  CAS  Google Scholar 

  12. Honkonen T, Kalsson H, Koivisto A-M, Stengård E, Salokangas RKR (2003) Schizophrenic patients in different treatment settings during the era of deinstitutionalization: 3-year follow-up of three discharge cohorts in Finland. Aust N Z J Psychiatry 37:160–168

    Article  PubMed  Google Scholar 

  13. Höyer EH, Mortensen PB, Olesen AV (2000) Mortality and causes of death in a total national sample of patients with affective disorders admitted for the first time between 1973 and 1993. Br J Psychiatry 176:76–82

    Article  PubMed  Google Scholar 

  14. Joukamaa M, Heliövaara M, Knekt P, Aromaa A, Raitasalo R, Lehtinen V (2001) Mental disorders and cause-specific mortality. Br J Psychiatry 179:498–502

    Article  PubMed  CAS  Google Scholar 

  15. Kaltia-Heino R, Korkeila J, Tuohimäki C, Tuori T, Lehtinen V (2000) Coercion and restrictions in psychiatric inpatient treatment. Eur Psychiatry 15:213–219

    Article  Google Scholar 

  16. Korkeila JA, Lehtinen V, Tuori T, Helenius H (1998) Patterns of psychiatric hospital service use in Finland: a national register study of hospital discharges in the early 1990s. Soc Psychiatr Psychiatr Epidemiol 33:218–223

    Article  CAS  Google Scholar 

  17. Korkeila J, Tuohimäki C, Kaltiala-Heino R, Lehtinen V, Joukamaa M (2002) Predicting use of coercive measures in Finland. Nord J Psychiatry 56:339–345

    Article  PubMed  Google Scholar 

  18. Lahti RA, Penttilä A (2003) Cause-of-death query in validation of death ceritification by expert panel; effects on mortality statistics in Finland, 1995. For Sci Int 131:113–124

    CAS  Google Scholar 

  19. Lawrence D, Holman CDJ, Jablensky AV, Fuller SA, Stoney AJ (2001) Increasing rates of of suicide in Western Australian psychiatric patients: a record linkage study. Acta Psychiatr Scand 104:443–451

    Article  PubMed  CAS  Google Scholar 

  20. Lawrence D, Jablensky AV, Holman CDJ, Pinder TJ (2000) Mortality in western psychiatric patients. Soc Psychiatry Psychiatr Epidemiol 35:341–347

    Article  PubMed  CAS  Google Scholar 

  21. Mäkelä P, Valkonen T, Martelin T (1997) Contribution of deaths related to alcohol use to socioeconomic variation in mortality: register based follow up study. BMJ 315:211–216

    PubMed  Google Scholar 

  22. Mäkikyrö T, Karvonen JT, Hakko H, Nieminen P, Joukamaa M, Isohänni M, Jones P, Jarvelin MR (1998) Comorbidity of hospital-treated psychiatric and psysical disorders with special reference to schizoprenia: a 28 year follow-up pf the 1966 Northern Finland general population birth cohort. Public Health 112:221–228

    PubMed  Google Scholar 

  23. Meloni D, Miccinesi G, Bencini A, Conte M, Crocetti E, Zappa M, Ferrera M (2006) Mortality among discharged psychiatric patients in Florence, Italy. Psychiatr Serv 57:1474–1481

    Article  PubMed  Google Scholar 

  24. Mortensen PB, Juel K (1990) Mortality and causes of death in schizophrenic patients in Denmark. Acta Psychiatr Scand 81:372–377

    Article  PubMed  CAS  Google Scholar 

  25. Pirkola S, Sohlman B, Heilä H, Wahlbeck K (2007) Reductions in postdischarge suicide after deinstitutionalization and decentralization: a nationwide register study in Finland. Psychiatr Serv 58:221–226

    Article  PubMed  Google Scholar 

  26. Politi P, Piccinelli M, Klersy C, Madini S, Segagni LG, Fratti C, Barale F (2002) Mortality in Psychiatric patients 5–21 years after hospital admission in Italy. Psychol Med 32:227–237

    Article  PubMed  CAS  Google Scholar 

  27. Qin P, Nordentoft M (2005) Suicide risk in relation to psychiatric hospitalization. Arch Gen Psychiatry 62:427–432

    Article  PubMed  Google Scholar 

  28. Räsänen S, Hakko H, Viilo K, Meyer-Rochow V, Moring J (2003) Excess mortality among long-stay psychiatric patients in Northern Finland. Soc Psychiatry Psychiatr Epidemiol 38:297–304

    PubMed  Google Scholar 

  29. Ringbäck Weitoft G, Gullberg A, Rosen M (1998) Avoidable mortality among psychiatric patients. Soc Psychiatry Psychiatric Epidemiol 33:430–437

    Article  Google Scholar 

  30. Roick C, Fritz-Wieacker A, Matschinger H, Heider D, Schingler J, Riedel-Heller S, Angermeyer MC (2007) Health habits with patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 42:268–276

    Article  PubMed  Google Scholar 

  31. Salokangas R, Honkonen T, Stengård E, Koivisto A (2002) Mortality in schizophrenia during decreasing number of hospital beds in Finland. Schizophr Res 54:265–275

    Article  PubMed  Google Scholar 

  32. Samele C, Patel M, Boydell J, Leese M, Wessely S, Murray R (2007) Physical illness and lifestyle risk factors in people with their first presentation of psychosis. Soc Psychiatry Psychiatr Epidemiol 42:117–124

    Article  PubMed  Google Scholar 

  33. Schneider B, Muller MJ, Philipp M (2001) Mortality in affective disorders. J Affect Disord 65:263–274

    Article  PubMed  CAS  Google Scholar 

  34. Simpson JC, Ming TS (1996) Mortality among patients with schizophrenia. Shizophr Bull 22:485–497

    CAS  Google Scholar 

  35. Sohlman B, Lehtinen V (1999) Mortality among discharged psychiatric patients in Finland. Acta Psychiatr Scand 99:102–109

    Article  PubMed  CAS  Google Scholar 

  36. Suominen K, Isometsä E, Haukka J, Lönnqvist J (2004) Substance use and male gender as risk factors for deaths and suicide. Soc Psychiatry Psychiatr Epidemiol 39:720–724

    Article  PubMed  Google Scholar 

  37. Tidemalm D, Elofsson S, Stefansson CG, Waern M, Runeson B (2005) Predictors of suicide in a community-based cohort of individuals with severe mental disorder. Soc Psychiatry Psychiatr Epidemiol 40:595–600

    Article  PubMed  Google Scholar 

  38. Valenti M, Necozione S, Busellu G, Borrelli G, Lepore AR, Madonna R (1997) Mortality in psychiatric hospital patients: a cohort analysis of prognostic factors. Int J Epidemiol 26:1227–1235

    Article  PubMed  CAS  Google Scholar 

  39. Verdoux H, Cougnard A, Grolleau S, Besson R, Delcroix F (2005) How do general practitioners manage subjects with early schizophrenia and collaborate with mental health professionals? Soc Psychiatry Psychiatr Epidemiol 40:892–989

    Article  PubMed  Google Scholar 

  40. Yin PHW, Yip PSF, Li RHY, Dunn ELW, Yeung WS, Miao YK (2004) Suidice after discharge from psychiatric inpatient care: a case-conrol study in Hong Kong. Aust N Z J Psychiatry 38:65–72

    Article  Google Scholar 

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Authors and Affiliations

  1. Tampere School of Public Health, University of Tampere, 33014, Tampere, Finland

    Heidi Honkonen BM, Aino K. Mattila MD, Riina Haataja MSc & Matti Joukamaa MD, PhD

  2. Dept. of Adult Psychiatry, Tampere University Hospital, Tampere, Finland

    Aino K. Mattila MD, Klaus Lehtinen MD, PhD & Matti Joukamaa MD, PhD

  3. Satakunta Hospital District, Psychiatric Division, Harjavalta Hospital, Harjavalta, Finland

    Teemu Elo MD

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  1. Heidi Honkonen BM
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  2. Aino K. Mattila MD
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  3. Klaus Lehtinen MD, PhD
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  4. Teemu Elo MD
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  5. Riina Haataja MSc
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  6. Matti Joukamaa MD, PhD
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Correspondence to Heidi Honkonen BM.

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Honkonen, H., Mattila, A.K., Lehtinen, K. et al. Mortality of Finnish acute psychiatric hospital patients. Soc Psychiat Epidemiol 43, 660–666 (2008). https://doi.org/10.1007/s00127-008-0344-y

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  • DOI: https://doi.org/10.1007/s00127-008-0344-y

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