488 – Mortality in people with serious mental illness in a psychiatric hospital in Greece

Abstract

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.

Analysis of fatalities of hospitalized patients of the clinic for mental disorders Dr Laza Lazarevic in 2011 and 2012

“…Approximately equal average age of the hospitalized patients with fatal outcomes was shown in their work by Argyropoulos et al (64 years) [12].…”

Effectiveness of clinical pharmacist interventions in optimizing pharmacotherapy for somatic comorbidities in serious mental illness: A clinical audit

“…, 4. , 5. , 6 This disparity is further heightened by a higher prevalence of somatic comorbidities, including cardiovascular disorders (CVD), COPD, cancers, diabetes, and liver diseases in those with SMI.…”

“… 6 Notably, 74% of SMI patients who died in psychiatric settings had comorbidities like hypertension, diabetes, and CVD. 5 These somatic illnesses, particularly CVD, play a major role in the elevated mortality rates within this group. 2 , 5 …”

“… 5 These somatic illnesses, particularly CVD, play a major role in the elevated mortality rates within this group. 2 , 5 …”

“… 2 An interesting observation is that individuals with SMI and concurrent somatic disorders are more likely to be hospitalized than those with the same somatic conditions alone. 6 Respiratory disorders and CVD are the leading causes of mortality in psychiatric hospitals, 5 highlighting the need for improved pharmacotherapy management to optimize disease outcomes in SMI. 6 …”