Life expectancies for individuals with psychiatric diagnoses.
ABSTRACT The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.
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ABSTRACT: It is well established that serious mental illness is associated with raised mortality, yet few studies have looked at the life expectancy of people with personality disorder (PD). This study aims to examine the life expectancy and relative mortality in people with PD within secondary mental health care. We set out to examine this using a large psychiatric case register in southeast London, UK. Mortality was obtained through national mortality tracing procedures. In a cohort of patients with a primary diagnosis of PD (n=1836), standardised mortality ratios (SMRs) and life expectancies at birth were calculated, using general population mortality statistics as the comparator. Life expectancy at birth was 63.3 years for women and 59.1 years for men with PD-18.7 years and 17.7 years shorter than females and males respectively in the general population in England and Wales. The SMR was 4.2 (95% CI: 3.03-5.64) overall; 5.0 (95% CI: 3.15-7.45) for females and 3.5 (95% CI: 2.17-5.47) for males. The highest SMRs were found in the younger age groups for both genders. People with PD using mental health services have a substantially reduced life expectancy, highlighting the significant public health burden of the disorder.Journal of psychosomatic research 08/2012; 73(2):104-7. DOI:10.1016/j.jpsychores.2012.05.001 · 2.84 Impact Factor
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ABSTRACT: Risk of retirement from work before statutory retirement age among employees with personality disorders is unknown. We used diagnoses of awarded medical rehabilitations and hospitalisations to select two clinical cohorts from a population of 151,618 employees: participants in rehabilitation (total N=1942, 233 personality disorder, 419 anxiety disorder and 1290 depression cases) and hospitalised patients (N=1333, 354, 126 and 853, respectively). Early retirement from work was tracked through national registers during a period of 5 years. Cox proportional hazard models were used to examine the association of diagnostic groups with risk of early retirement. In models adjusted for age, sex and socioeconomic position, the relative risk of early retirement for patients with personality disorders was 3.5-fold (95% CI 2.1 to 5.8) in the rehabilitation cohort and 2.3-fold (95% CI 1.6 to 3.5) in the hospital cohort compared with anxiety disorders. The corresponding hazard ratios of early retirement for personality disorders compared with depressive disorders were 1.1 (95% CI 0.8-1.5) and 1.7 (95% CI 1.4-2.1), respectively. Personality disorders increase the risk of early retirement at least to an equal extent as depression and more than twice that of anxiety disorders.European Psychiatry 01/2011; 26(1):18-22. DOI:10.1016/j.eurpsy.2009.12.022 · 3.21 Impact Factor
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ABSTRACT: The objective of this study was to follow the development of met and unmet needs in a sample of severely mentally ill after the 1995 Swedish mental health care reform and to analyse whether the efforts made by social services and mental health care have been more adequate since the reform. Inventories were made in 1995/1996, 2000/2001 and 2006 in an area of Sweden. A total of 171 persons who were considered to be severely mentally ill both in 1995/1996 and 2006, using the same criteria of definition, were interviewed using the same form of interview and their needs were assessed according to Camberwell Assessment of Need on all three occasions. The number of met needs had increased between 2006 and 1995/1996 and unmet needs in important need-domains had decreased. The changes in needs mostly referred to needs in the factor 'functional disability'. The degree of effort by psychiatric care and social services had increased. The number of wage-earners in the group had decreased to almost zero and the degree of social isolation had increased in 2006. The target group had made some progress referring to their functional disability and the efforts from services had increased. However, the integration in society had decreased in fundamental aspects.Social Psychiatry and Psychiatric Epidemiology 05/2008; 43(9):705-13. DOI:10.1007/s00127-008-0356-7 · 2.58 Impact Factor