[Mortality of mentally ill patients. Review of the literature]. 1992

M F Gausset, and F Casadebaig, and J M Guillaud-Bataille, and N Quemada, and J L Terra
Hôpital Saint-Jean-de-Dieu, Lyon.

Overmortality among psychiatric patients has been a regular observation from the XIXth century to nowadays. If the rates of mortality have decreased in these last fifty years, they still remain higher than in the general population Standardized Mortality Ratio (SMR) (two or three times greater than normal). The authors reviewed 53 recent articles from european, north american, japanese and israelian researches on this question. Most of them proceed from crossings between psychiatric case register and death-register, and concern inpatients only (Brook, Giel, Saugstad, Mortensen, Herman, Haugland, Rorsman, Sturt, Winokur, Zilber). Some take into account outpatients as well (Eastwood, Koranyi, Martin, Ribourdouille). SMR are calculated and comparisons are made between different groups by sex, age, diagnosis and cause of death. Those are usually divided into 2 categories: natural deaths somatic diseases) and unnatural deaths (suicides-accidents). RESULTS Among the patients, mortality rates are higher for men than women, but SMR are higher for women. The highest mortality relative risk is observed between 20 and 40 years of age. Except for three authors, unnatural deaths are not sufficient to explain overmortality. SMR for suicides and accidental deaths are decreasing with age; the relative risk is more important for outpatients, men, some specific diagnoses (affective disorders, acute schizophrenia) and during the first two years of the course of the illness. Suicide rates have been increasing among patients these last twenty years. Natural death is more frequent among patients with organic brain syndromes but is also in excess for the other patients. Cardiovascular diseases represent the first cause of mortality but infections (pneumonia-influenza) and metabolic diseases are over-represented.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D011619 Psychotropic Drugs A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). Psychoactive Agent,Psychoactive Agents,Psychoactive Drug,Psychopharmaceutical,Psychopharmaceuticals,Psychotropic Drug,Psychoactive Drugs,Agent, Psychoactive,Agents, Psychoactive,Drug, Psychoactive,Drug, Psychotropic,Drugs, Psychoactive,Drugs, Psychotropic
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D002423 Cause of Death Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. Causes of Death,Death Cause,Death Causes
D006778 Hospitals, Psychiatric Special hospitals which provide care to the mentally ill patient. Mental Hospitals,Hospitals, Mental,Mental Institutions,Psychiatric Hospitals,Hospital, Mental,Hospital, Psychiatric,Institution, Mental,Institutions, Mental,Mental Hospital,Mental Institution,Psychiatric Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D000553 Ambulatory Care Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. Outpatient Care,Outpatient Health Services,Clinic Visits,Health Services, Outpatient,Outpatient Services,Services, Outpatient Health,Urgent Care,Care, Ambulatory,Care, Outpatient,Care, Urgent,Cares, Urgent,Clinic Visit,Health Service, Outpatient,Outpatient Health Service,Outpatient Service,Service, Outpatient,Service, Outpatient Health,Services, Outpatient,Urgent Cares,Visit, Clinic,Visits, Clinic
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D012737 Sex Factors Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances. Factor, Sex,Factors, Sex,Sex Factor

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