Psychiatric Centre Copenhagen, University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark.
PLoS One. 2013;8(1):e55176. doi: 10.1371/journal.pone.0055176. Epub 2013 Jan 25.
Excess mortality among patients with severe mental disorders has not previously been investigated in detail in large complete national populations.
To investigate the excess mortality in different diagnostic categories due to suicide and other external causes of death, and due to specific causes in connection with diseases and medical conditions.
In longitudinal national psychiatric case registers from Denmark, Finland, and Sweden, a cohort of 270,770 recent-onset patients, who at least once during the period 2000 to 2006 were admitted due to a psychiatric disorder, were followed until death or the end of 2006. They were followed for 912,279 person years, and 28,088 deaths were analyzed. Life expectancy and standardized cause-specific mortality rates were estimated in each diagnostic group in all three countries.
The life expectancy was generally approximately 15 years shorter for women and 20 years shorter for men, compared to the general population. Mortality due to diseases and medical conditions was increased two- to three-fold, while excess mortality from external causes ranged from three- to 77-fold. Mortality due to diseases and medical conditions was generally lowest in patients with affective disorders and highest in patients with substance abuse and personality disorders, while mortality due to suicide was highest in patients with affective disorders and personality disorders, and mortality due to other external causes was highest in patients with substance abuse.
These alarming figures call for action in order to prevent the high mortality.
在大型完整的全国人群中，先前并未详细研究过严重精神障碍患者的超额死亡率。
调查因自杀和其他外部死亡原因以及与疾病和医疗状况有关的特定原因导致的不同诊断类别的超额死亡率。
在丹麦、芬兰和瑞典的纵向国家精神病病例登记处，对 270770 名近期发病的患者进行了队列研究，这些患者在 2000 年至 2006 年期间至少因精神障碍住院一次。随访至死亡或 2006 年底。他们随访了 912279 人年，分析了 28088 例死亡。在所有三个国家/地区的每个诊断组中，估计了预期寿命和标准化的特定原因死亡率。
与普通人群相比，女性的预期寿命通常缩短约 15 年，男性缩短约 20 年。与疾病和医疗状况相关的死亡率增加了两到三倍，而外部原因导致的超额死亡率范围从三倍到 77 倍。与疾病和医疗状况相关的死亡率在情感障碍患者中通常最低，在物质滥用和人格障碍患者中最高，而在情感障碍和人格障碍患者中，自杀导致的死亡率最高，在物质滥用患者中，其他外部原因导致的死亡率最高。
这些令人震惊的数字呼吁采取行动，以防止高死亡率。
