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The British Journal of Psychiatry (2003) 182: 31-36
© 2003 The Royal College of Psychiatrists

Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980-1998

DAVID M. LAWRENCE, PhD and CASHEL D'ARCY J. HOLMAN, PhD

Department of Public Health, The University of Western Australia, Perth, Western Australia

ASSEN V. JABLENSKY, DMSc

Department of Psychiatry and Behavioural Science, The University of Western Australia, Perth, Western Australia

MICHAEL S. T. HOBBS, DPhil

Department of Public Health, The University of Western Australia, Perth, Western Australia

Correspondence: David Lawrence, Centre for Developmental Health, Curtin University of Technology, Telethon Institute for Child Health Research, PO Box 855, West Perth WA 6872, Australia. Tel: +61 8 9489 7720; fax: +61 8 9489 7700; e-mail: dlawrence{at}ichr.uwa.edu.au

Declaration of interest None. Study funded by National Health and Medical Research Council of Australia. Setting up of Western Australian (WA) Health Services Research Linked Database funded by Lotteries Commission.

Background People with mental illness suffer excess mortality due to physical illnesses.

Aims To investigate the association between mental illness and ischaemic heart disease (IHD) hospital admissions, revascularisation procedures and deaths.

Method A population-based record-linkage study of 210 129 users of mental health services in Western Australia during 1980-1998. IHD mortality rates, hospital admission rates and rates of revascularisation procedures were compared with those of the general population.

Results IHD (not suicide) was the major cause of excess mortality in psychiatric patients. In contrast to the rate in the general population, the IHS mortality rate in psychiatric patients did not diminish over time. There was little difference in hospital admission rates for IHD between psychiatric patients and the general community, but much lower rates of revascularisation procedures with psychiatric patients, particularly in people with psychoses.

Conclusions People with mental illness do not receive an equitable level of intervention for IHD. More attention to their general medical care is needed.


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