Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

01-08-2008 | ORIGINAL PAPER

Mortality of Finnish acute psychiatric hospital patients

Authors: Heidi Honkonen, BM, Aino K. Mattila, MD, Klaus Lehtinen, MD, PhD, Teemu Elo, MD, Riina Haataja, MSc, Matti Joukamaa, MD, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2008

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.

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 166:783–788PubMed

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 33:491–496PubMedCrossRef

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

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

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

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

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

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

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 154:1235–1242PubMed

10.

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

11.

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

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 37:160–168PubMedCrossRef

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 176:76–82PubMedCrossRef

14.

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

15.

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

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 33:218–223CrossRef

17.

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

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

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 104:443–451PubMedCrossRef

20.

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

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 315:211–216PubMed

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 112:221–228PubMed

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 57:1474–1481PubMedCrossRef

24.

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

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 58:221–226PubMedCrossRef

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 32:227–237PubMedCrossRef

27.

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

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 38:297–304PubMed

29.

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

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 42:268–276PubMedCrossRef

31.

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

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 42:117–124PubMedCrossRef

33.

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

34.

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

35.

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

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 39:720–724PubMedCrossRef

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 40:595–600PubMedCrossRef

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 26:1227–1235PubMedCrossRef

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 40:892–989PubMedCrossRef

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 38:65–72CrossRef

Title: Mortality of Finnish acute psychiatric hospital patients
Authors: Heidi Honkonen, BM
Aino K. Mattila, MD
Klaus Lehtinen, MD, PhD
Teemu Elo, MD
Riina Haataja, MSc
Matti Joukamaa, MD, PhD
Publication date: 01-08-2008
Publisher: D. Steinkopff-Verlag
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 8/2008
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-008-0344-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mortality of Finnish acute psychiatric hospital patients

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2008

Mortality associated with depression

Measuring common mental disorders in women in Ethiopia

Do needs, symptoms or disability of outpatients with schizophrenia influence family burden?

The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students

Descriptive epidemiology of intimate partner aggression in Ukraine

Psychotic experiences in people who have been sexually assaulted