Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA.
Can J Psychiatry. 2012 Aug;57(8):505-11. doi: 10.1177/070674371205700809.
Psychiatric comorbidities are common among psychiatric patients and typically associated with poorer clinical prognoses. Subjects of a large Danish birth cohort were used to study the relation between mortality and co-occurring psychiatric diagnoses.
We searched the Danish Central Psychiatric Research Registry for 8109 birth cohort members aged 45 years. Lifetime psychiatric diagnoses (International Classification of Diseases, Revision 10, group F codes, Mental and Behavioural Disorders, and one Z code) for identified subjects were organized into 14 mutually exclusive diagnostic categories. Mortality rates were examined as a function of number and type of co-occurring diagnoses.
Psychiatric outcomes for 1247 subjects were associated with 157 deaths. Early mortality risk in psychiatric patients correlated with the number of diagnostic categories (Wald χ² = 25.0, df = 1, P < 0.001). This global relation was true for anxiety and personality disorders, but not for schizophrenia and substance abuse, which had intrinsically high mortality rates with no comorbidities.
Risk of early mortality among psychiatric patients appears to be a function of both the number and the type of psychiatric diagnoses.
精神科合并症在精神科患者中很常见，通常与较差的临床预后相关。利用丹麦一个大型出生队列的受试者来研究死亡率与同时存在的精神科诊断之间的关系。
我们在丹麦中央精神科研究登记处搜索了 8109 名年龄在 45 岁的出生队列成员。对已识别出的受试者进行了一生中的精神科诊断（国际疾病分类，第 10 版，F 组代码，精神和行为障碍，以及一个 Z 代码），并将其组织成 14 个相互排斥的诊断类别。检查了死亡率与共病诊断的数量和类型的关系。
1247 名受试者的精神科结局与 157 例死亡相关。精神科患者的早期死亡风险与诊断类别数量相关（Wald χ²=25.0，df=1，P<0.001）。这种整体关系适用于焦虑和人格障碍，但不适用于精神分裂症和物质滥用，这些疾病的死亡率本来就很高，且没有共病。
精神科患者的早期死亡风险似乎是精神科诊断数量和类型的共同作用。
