Department of Behavioral and Community Health Sciences, NortheasternOhio Universities Colleges of Medicine and Pharmacy, 4209 State Route 44, Rootstown, OH 44272, USA.
Psychiatr Serv. 2010 Jul;61(7):663-8. doi: 10.1176/ps.2010.61.7.663.
The primary aim of this retrospective study of death records was to determine whether there were significant differences in years of potential life lost (YPLL) between decedents with serious and persistent mental illness at a community mental health center (N=647) and decedents in the general population (N=15,517) after the analysis adjusted for sociodemographic factors and cause of death.
Clinical case management files from a community mental health center were matched to state death records from 1998 to 2004 to identify decedents being treated for a serious and persistent mental illness. Differences in leading causes of death and YPLL were calculated with descriptive and multivariate methods.
Mean+/-SD YPLL for the decedents with serious and persistent mental illness was 14.5+/-10.6, compared with 10.3+/-6.7 for the general population. Heart disease was the leading cause of death for both groups. Mean differences in YPLL after adjustment for gender, race, marital status, and education ranged from 1.7 years for chronic lower respiratory disease to 13.1 years for accidents and were significant for every leading cause of death. Differences in cause of death did not explain the difference in YPLL. Suicide, cancer, accidents, liver disease, and septicemia were differentially associated with YPLL for persons with serious and persistent mental illness.
Suicide, cancer, accidents, liver disease, and septicemia increased premature mortality among persons with serious and persistent mental illness. Along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on these preventable causes of early death.
本回顾性死亡记录研究的主要目的是确定在社区心理健康中心接受严重和持续精神疾病治疗的死者（N=647）与普通人群（N=15517）在调整社会人口统计学因素和死亡原因后，潜在寿命损失（YPLL）的年数是否存在显著差异。
从社区心理健康中心的临床病例管理档案中匹配 1998 年至 2004 年的州死亡记录，以确定正在接受严重和持续精神疾病治疗的死者。使用描述性和多变量方法计算主要死因和 YPLL 的差异。
严重和持续精神疾病死者的平均+/-SD YPLL 为 14.5+/-10.6，而普通人群为 10.3+/-6.7。心脏病是两组的主要死因。调整性别、种族、婚姻状况和教育程度后，YPLL 的平均差异范围从慢性下呼吸道疾病的 1.7 年到意外事故的 13.1 年不等，对于每种主要死因均具有统计学意义。死因差异并不能解释 YPLL 的差异。自杀、癌症、意外事故、肝病和败血症与严重和持续精神疾病患者的 YPLL 差异相关。
自杀、癌症、意外事故、肝病和败血症增加了严重和持续精神疾病患者的过早死亡。除了持续的自杀预防计划外，整合初级保健和精神保健的努力应重点关注这些可预防的早逝原因。
