Clinical Profile of Mortality among Chronic Schizophrenic Patients: A Local Pilot Survey in Iran

Abstract

Background: Many scholars believe that mental disorders may increase the risk of mortality among psychiatric patients in comparison with ordinary people. Unfortunately, since there is no systematic psychiatric case register system in Iran, a precise study of the rate of mortality of psychiatric patients in Iran is not easy. Objective: The objective of the current study included estimation of the rate of mortality and clinical profile of the died patients in a group of non-western aged schizophrenic patients. Methods: Senior section of Razi psychiatric hospital was selected as the specific field of investigation, and all elderly schizophrenic patients (≥65 years old), who had been hospitalized there, were nominated as the accessible sample and estimated with respect to the objectives of the present assessment. For survey, all deaths in the said district, which had occurred throughout the last sixty months (April of 2014-August 2019), had been listed by the supervisor of the mortality committee of the hospital. The clinical diagnosis was based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition, criteria. Results: Among 840 chronic elderly schizophrenic patients, 69 deaths were registered by the mortality committee of the hospital. As evident by the results, the annual rate of mortality among elderly schizophrenic patients in the present assessment was around 0.015 (0.15 per 1,000 individuals per year) and 0.017 (0.17 per 1,000 individuals per year) among male and female aged patients, respectively, which was significantly lower than the native crude death rate. While the average age of the expired female patients was significantly longer than male cases, the life expectancy of both male and female patients was significantly shorter than the life expectancy of native people. Besides, while among the present sample of old schizophrenics cardiac disease was the main leading cause of death, other causes, like violence, suicide, road traffic accidents, falls, fires, drug use, tuberculosis, drowning, epilepsy, and Parkinson’s disease were not liable at all. Conclusion: While the rate of mortality among aged schizophrenics was significantly lower than the native crude death rate, the age of the expired female patients was significantly longer than the male cases and the life expectancy of both male and female patients was significantly shorter than the life expectancy of native people. Cardiac disorder was the leading cause of death among the present sample of aged schizophrenics.