Mortality among persons with a history as psychiatric inpatients with functional psychosis

Background: An important aim in all psychiatric care should he a reduction of overall mortality. information on mortality patterns in different types of psychiatric populations is vital for a successful design of treatment strategies and preventive programmes. The present study aims to describe mortality among persons with a history as psychiatric inpatients with functional psychosis. Methods: All psychiatric inpatients, 17,878 men and 23,256 women, registered in the Swedish National Hospital Discharge Registry between 1978 and 1982 with a functional psychosis(ICD-8 = 295-299) as principal diagnosis were followed for mortality during the time period 1983-85. Life tables were constructed and death rates for various types of causes of death were calculated. Results: Compared to the general population, the excess mortality in the study group caused a reduction in Life expectancy of 22.1-27.9% (95% CI) among the men and 15.0-21.7% among the women. In the age group 20-49 years, 62% of the excess mortality was caused by suicide. In the age group 50-89 years, only 8% of the excess was suicide, while 52% was caused by cardiovascular disorders. Conclusions: Reduction in mortality rates requires different strategies in different age groups. Even if the suicide rate were reduced to zero, it would only have a marginal influence on the highly elevated mortality among patients in upper middle age and among the elderly. Among the younger patients (<35 years), on the other hand, practically all excess mortality was caused by suicide and accidents.