Death in aftercare

Abstract

Modern studies on the mortality risk of persons with psychiatric illness have viewed the problem from a variety of different perspectives. Shinozaki 1 found the death rate among inpatients in a group of Japanese mental hospitals to be seven times the death rate of the general population. Other studies have identified persons at the time of hospital admission or discharge and presented mortality data on follow-up. Affleck et al. 2 after 12 years, found an average annual mortality more than three times greater than the general population for schizophrenic women. Zitrin et al. 3 noted a death rate double the expected rate among 867 persons discharged from the psychiatric unit of New York's Bellevue Hospital and followed-up at 2 years. Tsuang and Woolson 4 report increased mortality risk after four decades of follow-up in Iowa. The mortality risk varied with decade of follow-up, sex, and diagnosis but was highest for schizophrenics in the first decade of follow-up. Mortality rates among mixed groups of inpatients and outpatients are also reported. Babigian and Odoroff 5 found the relative risk of death for persons seeking psychiatric care in Monroe County, New York to be 2.5 to 3 times greater than that of the general population. Innes and Miller 6 found an overall death rate twice the expected rate for a group of inpatients and outpatients at 5-year follow-up in Scotland. Rorsman 7 noted a death rate approximately 1.6 times the expected rate for a group of mainly nonpsychotic inpatients and outpatients in Sweden. Two studies, Sims 8 and Keehn et al. 9 report excess mortality among patients with exclusively nonpsychotic diagnoses. A single known study, Claghorn and Kinross-Wright 10 found no increased mortality among a group of psychiatric patients followed-up for 2 1 2 years.