Introduction:Patients with schizophrenia seem to have a higher mortality and a lower life expectancy compared to the general population.Aims:To estimate the rate of mortality at a psychiatric hospital and to identify the causes and risk factors of these deaths.Methods:A retrospective study was conducted based on the medical records of patients who had died during the time period from January 2007 to March 2012 at the 250-bed Psychiatric Hospital of Tripolis in Greece.Results:A total of 39 deaths were recorded (mean annual mortality: 1.7 per 1000 inpatients). Patients were predominantly male (67%), mean age 64 years, most of them farmers (41%), with low educational level (69%) and mainly unmarried (72%). Medical co-morbidity was observed in 74% of the cases, mainly hypertension, diabetes and cardiovascular diseases. In 59% hospitalization was made after a court order. Thirty two patients were diagnosed with schizophrenia, mainly of the paranoid form (77%). Haloperidol was the most prescribed antipsychotic drug (62%). The main causes of mortality were respiratory and cardiovascular diseases (each 59%). Six of the occurred deaths could not be determined, but autopsy classified them as natural cause of death.Conclusions:Low rate of mortality, no clear forensic responsibility and high rates of medical co-morbidities in schizophrenia patients were observed in this study. The implementation of medical screening and prevention programs of serious health problems should be a high priority in psychiatric hospitals in order to improve quality of life and extend life expectancy in mentally ill adults.

Introduction:Sleep problems are common in older people and often associated with mood disorders, such as anxiety or depression.Aims:The present study examined the association between sleep disturbances in older adults and frequency of depressed mood and other aggravating factors.Methods:The sample consisted of 139 subjects, aged >65 years, members of day care center for older people (KAPI) in the municipality of Tripolis, Greece. Geriatric Depression Scale (GDS-15) was applied, to screen the elderly for depression. Athens Insomnia Scale (AIS), a self-assessment psychometric instrument, was used to quantify sleep difficulty. Statistics was processed with SPSS 17.0.Results:56.8% of older people reported inadequate sleep, based on AIS. According to GDS-15, 53.3% of the studied population screened positive for depressive symptoms (43.2% moderate, 10.1% severe). In 79 persons who reported insomnia, 70.9% and 17.7% observed moderate and severe depression respectively, applying the GDS-15. Sleep disorders were more frequent in women (67.7% vs 48.1%, p=0.02), in not married, including divorced and widowed, (85.2% vs 44.7%, p=0.004) and in subjects without children (91.7% vs 53.2%, p=0.25). Insomnia was common in elderly with chronic diseases compared to elderly without co-morbidity (65.8% vs 9.1%, p<0.001), in participants with low monthly income (98.1% vs 1.9%, p<0.001) and in older adults suffering from depression (88.6% vs 6.7%. p<0.001).Conclusions:Sleep disorders between the elderly of this study are common and strongly associated with depression. Determining the causality of the sleep disturbance could help to treat insomnia in the elderly and improve overall their health.