Mortality Among Patients with Psychiatric Illness a Ten-Year Case Register Study in an Area with a Community-based System of Care

Amaddeo, Francesco; Bisoffi, Giulia; Bonizzato, Paola; Micciolo, Rocco; Tansella, Michele

doi:10.1192/bjp.166.6.783

Cited by 75 publications

(72 citation statements)

References 13 publications

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“…The negative trend in relationship between the mortality rate and the time interval since registration, found in our previous study (Amaddeo et al 1995), was confirmed and the time extension of our study to 20 years has made the results more robust.…”

Section: Discussionsupporting

confidence: 63%

“…Compared to the previous mortality study by Amaddeo et al (1995), the current study followed up 10.14** 6.4-16.1 Traumatic episodes 7.91** 4.9-12.5 4.03** 2.9-5.6 1.5 0.8-2.9 6.40** 3.5-11.5 11.03** 7.8-15.5 3.62** 1.7-7.6 3.32** 2.2-4.9…”

Section: Discussionmentioning

confidence: 99%

“…This research allowed us to repeat the mortality analyses published in a previous study by Amaddeo et al (1995) conducted in South Verona for a time period of 10 years, on a sample followed up for a twofold longer period, also adding a detailed analysis of causes of death that was not possible to perform in our previous study because of the small sample size.…”

Section: Introductionmentioning

confidence: 99%

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Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

et al. 2009

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Background. Most mortality studies of psychiatric patients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatric patients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services.Method. All subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population.Results. The overall SMR of the psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95 % confidence interval (CI) 1.6-1.8], and higher still following the first admission (SMR 2.61, 95 % CI 2.4-2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95 % CI 142.5-328.6) and personality disorders (20.87, 95 % CI 5.2-83.4).Conclusions. This study found that psychiatric patients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

et al. 2009

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“…Fortunately, some psychiatric case registers include outpatient and community-based treatment. For example, Amaddeo et al 12 undertook a 10-year follow-up of over 3000 patients, most of whom only received outpatient or community-based care. They estimated an SMR of 2.2 for inpatients and 1.3 for outpatients.…”

Section: Excess Mortality By Settingmentioning

confidence: 99%

The Epidemiology of Excess Mortality in People with Mental Illness

2010

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T he excess mortality of people with mental illness has been known for many years. In 1841, William Farr 1 reported to the Royal Statistical Society on mortality within the major asylums and licensed houses of the period in England. He estimated, using life-table methods, the mortality rate in the best facility to be about 3 times that of the general population, and mortality in other facilities to be several times higher again. The report inspired the British parliament to require regular compilation of statistics within all asylums, and established mortality rate as a measure of the quality of care provided. The high mortality was attributed to infectious diseases and the poor conditions within the asylums, such as lack of exercise and warmth, poor diet, and lack of medical care. During subsequent years, mortality in people with mental illness has been the subject of hundreds of studies. In the most comprehensive meta-analyses to date, Harris and Barraclough 2,3 identified 152 reports on all-cause mortality and 249 on suicide. They found that all mental disorders were associated with an increased risk of premature death. Overall

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“…Contributing to this is the socioeconomic condition of those with schizophrenia (which may lessen their access to health care); difficulties, inherent in the condition, of following medical regimens; and the possibility that psychiatric treatment increases the risks. 23,24 The move from hospital to the community seems to have resulted in a relative rise in cardiovascular deaths and unnatural deaths for both men and women, but most pronounced in men, 25 probably via the route of homelessness and consequent lack of supervision and health care.…”

Section: Mortalitymentioning

confidence: 99%

An Outcome Measure in Schizophrenia: Mortality

Seeman

2007

Can J Psychiatry

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Objective: To determine the current outcome of schizophrenia, with mortality rate as the outcome measure. Method: Recent health, suicide, victim of violence, and mortality statistics were reviewed. Results: The general health of individuals with schizophrenia suffers from neglect, poor life style choices, and current treatments that increase death rates. Conclusion: Mortality in schizophrenia is rising, and it is the responsibility of physicians and health care planners to intervene.

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Mortality Among Patients with Psychiatric Illness a Ten-Year Case Register Study in an Area with a Community-based System of Care

Abstract: The overall mortality of psychiatric patients treated in a community-based system of care was higher than expected, but lower than the mortality reported in other psychiatric settings. The highest mortality risk was found in the first year after registration.

Cited by 75 publications

References 13 publications

Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

The Epidemiology of Excess Mortality in People with Mental Illness

An Outcome Measure in Schizophrenia: Mortality

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