Mortalität hospitalisierter psychiatrischer Patienten - Ergebnisse einer 10-Jahres-Studie

Abstract

The mortality rate of 1239 psychiatric patients--609 men and 639 women, aged between 40 and 70 years, permanently hospitalized in 6 different German clinics--was registered, ten years after they had been examined for the incidence of cardiac risk factors in 1971 and 1972. The death rate figures were compared with the corresponding figures of the total population of the Federal Republic of Germany. In all age-groups mortality among psychiatric patients, both male and female, was higher than the average rate at Federal level. The gap narrowed with increasing age. With male patients the most frequent cause of death were cardiovascular diseases, followed by respiratory diseases and malignant growths, whereas with women respiratory diseases were the primary cause of death. In comparison to the population of the Federal Republic of Germany considerably more patients died of respiratory diseases--according to age and sex the death rate was up to ten times higher. This was due to the high percentage of lethal pneumonia. The number of deaths in which the cause was unknown was also higher than the national average. A remarkably high percentage of the patients (27%) died suddenly and unexpectedly. In some age-groups fewer patients died of malignant growths than at Federal level. Death caused by cardiovascular diseases was only more frequent among younger patients. Among men acute ischaemic heart diseases were the most frequent cause of cardiac failure. Death due to cerebral sclerotic diseases was remarkably reduced among older patients, probably as a result of a less high incidence of hypertension.

Risk of stroke with typical and atypical anti-psychotics: a retrospective cohort study including unexposed subjects

“…For example, schizophrenia patients were reported to have an abnormally high prevalence of transient cerebral ischemia (Curkendall et al, 2004), their actual and 10-year risk of stroke (McCreadie, 2003;Curkendall et al, 2004) was almost two-fold that of the general population and they presented an excess of cerebrovascular mortality (Brook, 1985;Allebech, 1986;Osby et al, 2000;Joukamaa et al, 2001). In turn, patients with depression or bipolar disorder were found to have abnormally high risk of dying from cerebrovascular accidents (Schwalb, 1987;Zheng et al, 1997;Schwalb and Schwalb;Osby et al, 2001;Angst et al, 2002).…”

Tabakabhängigkeit und Raucherentwöhnung bei psychiatrischen Patienten

“…Untersuchungen zur Übersterblichkeit psychiatrischer Patienten mit affektiven oder schizophrenen Psychosen beziehen sich zumeist auf dauerhospitalisierte Patienten [21], die gleichzeitig auch eine Selektion von pflegebedürftigen und multimorbiden Patienten darstellen. Während früher dauerhospitalisierte Patienten häufig an einer Lungentuberkulose verstarben [23], wird die Mortalität heute von der Suizidalität, daneben aber auch von kardiovaskulären Erkrankungen und Atemwegserkrankungen (vor allem Pneumonien), von Verletzungen und Vergiftungen vor allem unter den jüngeren Patienten sowie plötzlichen Todesfällen an sogenannten ¹unklaren Todesursachenª bestimmt [18,20,24].…”

“…Obwohl dauerhospitalisierte Patienten häufig die Risikofaktoren Rauchen, Übergewicht und Immobilität aufweisen, können nicht alle Autoren eine erhöhte Sterblichkeit an kardiovaskulären Erkrankungen nachweisen [20]. Steinert u. Mitarb.…”