Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-17T09:07:59.471Z Has data issue: false hasContentIssue false
  • English
  • Français

Mortality and Causes of Death in First Admitted Schizophrenic Patients

Published online by Cambridge University Press:  02 January 2018

Preben Bo Mortensen  and
Knud Juel
Preben Bo Mortensen*
Affiliation:
Department of Psychiatric Demography, Institute of Basic Psychiatric Research, Psychiatric Hospital in Aarhus, DK-8240 Risskov, Denmark
Knud Juel
Affiliation:
Danish Institute for Clinical Epidemiology, Copenhagen, Denmark
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Although many studies have shown an increased mortality in schizophrenic patients, the literature provides little information about mortality from specific causes in relation to age, gender, and duration of illness. This study examined mortality and causes of death in a total national sample of 9156 first admitted schizophrenic patients. Suicide accounted for 50% of deaths in men and 35% of deaths in women. Suicide risk was particularly increased during the first year of follow-up. Death from natural causes, with the exception of cancer and cerebrovascular diseases, was increased. Suicide risk during the first year of follow-up increased by 56%, with a 50% reduction on psychiatric in-patient facilities. The study confirms that mortality in schizophrenia is still markedly elevated, and the finding of an increasing suicide risk may be an indicator of some adverse effects of deinstitutionalisation.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue 2 , August 1993 , pp. 183 - 189
Copyright
Copyright © Royal College of Psychiatrists, 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adler, L. E. & Griffith, J. M. (1991) Concurrent medical illness in the schizophrenic patient. Epidemiology, diagnosis, and management. Schizophrenia Research, 4, 91–107.CrossRefGoogle ScholarPubMed
Allebeck, P. (1989) Schizophrenia: a life-shortening disease. Schizophrenia Bulletin, 15, 81–89.Google Scholar
Allebeck, P., Varla, A. & Wistedt, B. (1986) Suicide and violent death among patients with schizophrenia. Acta Psychiatrica Scandinavica, 74, 43–94.Google Scholar
Allebeck, P. & Wistedt, B. (1986) Mortality in schizophrenia. A ten-year follow-up based on the Stockholm County in-patient register. Archives of General Psychiatry, 43, 650–653.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Black, D. W., Winokur, G. & Warrack, G. (1985) Suicide in schizophrenia: the Iowa Record Linkage Study. Journal of Clinical Psychiatry, 46, 14–17.Google ScholarPubMed
Black, D. W., (1988) Age, mortality and chronic schizophrenia. Schizophrenia Research, 1, 267–272.CrossRefGoogle ScholarPubMed
Breslow, N. E. & Day, N. E. (1987) Statistical Methods in Cancer Research Volume II - The Design and Analysis of Cohort Studies. Lyon: IARC Scientific Publications No. 82.Google Scholar
Breslow, N. E. (1984) Elementary methods of cohorts analyis. International Journal of Epidemiology, 13, 112–115.CrossRefGoogle Scholar
Brook, O. H. (1985) Mortality in the long-stay population of Dutch mental hospitals. Acta Psychiatrica Scandinavica, 71, 626–635.Google Scholar
Caldwell, C. B. & Gottesman, I. I. (1990) Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophrenia Bulletin, 16, 571–589.Google Scholar
Craig, T. J. & Lin, S. P. (1981) Mortality among psychiatric in-patients. Age-adjusted comparison of populations before and after psychotropic drug era. Archives of General Psychiatry, 38, 935–938.Google Scholar
Craig, T. J. & Kovasznay, B. (1988) Utilization of services. In Handbook of Schizophrenia. Vol. 3. Nosology, Epidemiology and Genetics of Schizophrenia (eds Tsuang, M. T. & Simpson, J. C.), pp. 399–436. Amsterdam: Elsevier.Google Scholar
Dupont, A. (1983) A national psychiatric case register as a tool for mental health planning, research, and administration. The Danish model. In Information Support to Mental Health Programs. An International Perspective (eds Laska, E. M., Gulbinat, W. H. & Regier, D. A.), pp. 257–274. New York: Human Sciences Press.Google Scholar
Eastwood, M. R., Stiasny, S., Meier, H. M., et al (1982) Mental illness and mortality. Comprehensive Psychiatry, 23, 377–385.Google Scholar
Eaton, W. W., Mortensen, P. B., Hermann, H., et al (1992) Long-term course of hospitalization for schizophrenia: Part I. Risk for rehospitalization. Schizophrenia Bulletin, 18, 217–227.CrossRefGoogle ScholarPubMed
Epilog Plus (1989) Statistical Package for Epidemiology and Clinical Trials. Pasadena: Epicenter Software.Google Scholar
Giel, R., Dijk, S. & Van Weerden, D. J. R. (1978) Mortality in the long-stay population of all Dutch mental hospitals. Acta Psychiatrica Scandinavica, 57, 361–368.Google Scholar
Herrman, H. E., Baldwin, J. A. & Christie, D. (1983) A record linkage study of mortality and general hospital discharge in patients diagnosed as schizophrenic. Psychological Medicine, 13, 581–593.Google Scholar
Hillard, J. R., Zung, W. W. & Ramm, D. (1985) Accidental and homicidal death in a psychiatric emergency room population. Hospital and Community Psychiatry, 36, 640–643.Google Scholar
Hollister, L. E. & Kosek, J. C. (1965) Sudden death during treatment with phenothiazine derivatives. Journal of the American Medical Association, 192, 93–96.Google Scholar
Hughes, J. R., Hatsukami, D. K., Mitchell, J. E., et al (1986) Prevalence of smoking among psychiatric out-patients. American Journal of Psychiatry, 143, 993–997.Google Scholar
Jones, G. R. (1985) Cancer therapy: phenothiazines in an unexpected role. Tumori, 71, 563–569.Google Scholar
Juul, S. (1984) Programmer til overlevelsesberegninger, rapp nr 1. Aarhus: Socialmedicinsk Institut, Aarhus Universitet.Google Scholar
Martin, R. L., Cloninger, C. R., Guze, S. B., et al (1985) Mortality in a follow-up of 500 psychiatric out-patients. U: Cause-specific mortality. Archives of General Psychiatry, 42, 58–66.Google Scholar
Masterson, E. & O'Shea, B. (1984) Smoking and malignancy in schizophrenia. British Journal of Psychiatry, 145, 429–432.CrossRefGoogle ScholarPubMed
Mortensen, P. B. (1987) Neuroleptic treatment and other factors modifying cancer risk in schizophrenic patients. Acta Psychiatrica Scandinavica, 75, 585–590.Google Scholar
Mortensen, P. B. (1989) The incidence of cancer in schizophrenic patients. Journal of Epidemiology and Community Health, 43, 43–47.Google Scholar
Mortensen, P. B. & Juel, K. (1990) Mortality and causes of death in schizophrenic patients in Denmark. Acta Psychiatrica Scandinavica, 81, 372–377.CrossRefGoogle ScholarPubMed
Munk-Jorgensen, P. (1987) Why has the incidence of schizophrenia in Danish psychiatric institutions decreased since 1970? Acta Psychiatrica Scandinavica, 75, 62–68.Google Scholar
Munk-Jorgensen, P. & Mortensen, P. B. (1989) Schizophrenia: a 13-year follow-up. Acta Psychiatrica Scandinavica, 79, 391–399.Google Scholar
Munk-Jorgensen, P. & Mortensen, P. B. & Machón, R. A. (1991) Hospitalization patterns in schizophrenia. A 13-year follow-up. Schizophrenia Research, 4, 1–9.CrossRefGoogle ScholarPubMed
Nielsen, P. E., Zacho, J., Olsen, J. A., et al (1988) Aendringer i danskemes rygevaner 1970–1987. Ugeskrift for Laeger, 150, 2229–2233.Google Scholar
Pokorny, A. D. (1960) Characteristics of 44 patients who subsequently committed suicide. Archives of General Psychiatry, 2, 314–323.Google Scholar
Risch, S. C., Groom, G. P. & Janowsky, D. S. (1981) Interfaces of psychopharmacology and cardiology - part two. Journal of Clinical Psychiatry, 42, 47–59.Google ScholarPubMed
Roy, A. (1982) Suicide in chronic schizophrenia. British Journal of Psychiatry, 141, 171–177.Google Scholar
Roy, A. (1986) Depression, attempted suicide, and suicide in patients with chronic schizophrenia. Psychiatric Clinics of North America, 9, 193–206.CrossRefGoogle ScholarPubMed
Rutstein, D. D., Berenberg, W., Chalmers, T. C., et al (1976) Measuring the quality of medical care. A clinical method. New England Journal of Medicine, 294, 582–588.CrossRefGoogle ScholarPubMed
Saugstad, L. F. & Ødegård, Ø. (1979) Mortality in psychiatric hospitals in Norway 1950–74. Acta Psychiatrica Scandinavica, 59, 431–447.Google ScholarPubMed
Saugstad, L. F. & Ødegård, Ø. (1985) Recent rise in supposedly stress dependent causes of death in psychiatric hospitals in Norway indicating increased ‘stress’ in hospitals? Acta Psychiatrica Scandinavica, 71, 402–409.CrossRefGoogle ScholarPubMed
Simpson, J. C. (1988) Mortality studies in schizophrenia. In Handbook of Schizophrenia. Vol. 3. Nosology, Epidemiology and Genetics of Schizophrenia (eds Tsuang, M. T. & Simpson, J. C.), pp. 245–274. Amsterdam: Elsevier.Google Scholar
Temoche, A., Pugh, T. F. & MacMahon, B. (1964) Suicide rates among current and former mental institution patients. Journal of Nervous and Mental Disease, 138, 124–130.Google Scholar
Tsuang, M. T. & Woolson, R. F. (1978) Excess mortality in schizophrenia and affective disoders. Do suicides and accidental deaths solely account for this excess? Archives of General Psychiatry, 35, 1181–1185.Google Scholar
Tsuang, M. T. & Woolson, R. F. & Fleming, J. A. (1980) Causes of death in schizophrenia and manic-depression. British Journal of Psychiatry, 136, 239–242.Google Scholar
Wolfersdorf, M., Keller, F., Schmidt, M. P. O., et al (1988) Are hospital suicides on the increase? A survey of reports on hospital suicides in the psychiatric literature of the 19th and 20th century. Social Psychiatry and Psychiatric Epidemiology, 23, 207–216.CrossRefGoogle Scholar
Wood, J. B., Evenson, R. C., Cho, D. W., et al (1985) Mortality variations among public mental health patients. Acta Psychiatrica Scandinavica, 72, 218–229.CrossRefGoogle ScholarPubMed
World Health Organization (1967) Manual of the International Statistical Classification of Disease, Injuries, and Cause of Death, 1965 revision (8th edn) (ICD-8). Geneva: WHO.Google Scholar
World Health Organization (1979) Schizophrenia. An International Follow-up Study. Toronto: John Wiley.Google Scholar
Zilber, N., Schufman, N. & Lerner, Y. (1989) Mortality among psychiatric patients-the groups at risk. Acta Psychiatrica Scandinavica, 79, 248–256.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.