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The British Journal of Psychiatry (2001) 179: 498-502
© 2001 The Royal College of Psychiatrists

Mental disorders and cause-specific mortality{dagger}

MATTI JOUKAMAA

Department of Psychiatry, Oulu University Hospital, Oulu

MARKKU HELIÖVAARA, PAUL KNEKT and ARPO AROMAA

National Public Health Institute, Helsinki

RAIMO RAITASALO

Social Insurance Institution, Helsinki

VILLE LEHTINEN

National Research and Development Centre for Welfare and Health, Helsinki, Finland

Correspondence: Matti Joukamaa, Department of Psychiatry, Oulu University Hospital, PO Box 5000, FIN-90401 Oulu, Finland. Tel: +358 8315 7374; fax: +358 8 333 167; e-mail: matti.joukamaa{at}oulu.fi

Declaration of interest This study was funded by the Social Insurance Institution of Finland.

{dagger} See editorial, pp. 477–478, this issue.

Background The impact of clinically diagnosed mental disorders on mortality in the general population has not been established.

Aims To examine mental disorders for their prediction of cause-specific mortality.

Method Mental disorders were determined using the 36-item version of the General Health Questionnaire and the Present State Examination in a nationally representative sample of 8000 adult Finns.

Results During the 17-year follow-up period 1597 deaths occurred. The presence of a mental disorder detected at baseline was associated with an elevated mortality rate. The relative risk in men was 1.6(95% confidence interval 1.3-1.8) and in women, 1.4 (95% Cl 1.2-1.6). In men and women with schizophrenia the relative risks of death during the follow-up period were 3.3 (95% Cl 2.3-4.9) and 2.3 (95% Cl 1.3-3.8) respectively, compared with the rest of the sample. In both men and women with schizophrenia the risk of dying of respiratory disease was increased, but the risk of dying of cardiovascular disease was increased only in men with neurotic depression.

Conclusions Schizophrenia and depression are associated with an elevated risk of natural and unnatural deaths.


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