Excess mortality among psychiatric patients. The Iowa Record-Linkage Study
D. W. Black, G. Warrack and G. Winokur
Of 5,412 patients admitted to the University of Iowa Psychiatric Hospital
between Jan 1, 1972, and Dec 31, 1981, three hundred thirty-one died during
the follow-up period, significantly more than expected. The risk for
premature death was greatest among women and the young, especially those
between the ages of 30 and 39 years. Risk was associated with all
psychiatric diagnoses and was significantly higher among patients of either
sex with an organic mental disorder or schizophrenia; women with acute
schizophrenia, depressive neuroses, alcoholism, drug abuse, and
psycho-physiologic disorders and special symptoms; and men with neuroses.
Suicide and accidental death were more frequent than expected and were
responsible for two thirds of the excess deaths. During the total time of
follow-up, women were at risk for natural deaths but men were not. Our most
important finding was that 99% of the excess deaths occurred within two
years of discharge. During this period there were undue numbers of both
"natural" and "unnatural" deaths. The first two years after discharge are a
time of great risk for psychiatric patients, particularly women.
Are Psychiatrist Characteristics Associated With Postdischarge Suicide of Schizophrenia Patients?
Lee and Lin
Schizophr Bull 2008;0:sbn007v1-sbn007.
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Mortality Among Discharged Psychiatric Patients in Florence, Italy
Meloni et al.
Psychiatr. Serv. 2006;57:1474-1481.
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Mortality of Mental Health Service Recipients in Vermont and Oklahoma
Pandiani et al.
Psychiatr. Serv. 2002;53:1025-1027.
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Cause-specific mortality in psychiatric patients after deinstitutionalisation
HANSEN et al.
Br. J. Psychiatry 2001;179:438-443.
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Is Suicide Contagious? A Study of the Relation between Exposure to the Suicidal Behavior of Others and Nearly Lethal Suicide Attempts
Mercy et al.
Am J Epidemiol 2001;154:120-127.
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Affective Disorders and Suicide Risk: A Reexamination
Bostwick and Pankratz
Am. J. Psychiatry 2000;157:1925-1932.
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The Role of Psychiatrists in Primary Care of Patients With Severe Mental Illness
Golomb et al.
Psychiatr. Serv. 2000;51:766-773.
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Life Expectancy and Causes of Death in a Population Treated for Serious Mental Illness
Dembling et al.
Psychiatr. Serv. 1999;50:1036-1042.
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Depression and the Course of Coronary Artery Disease
Glassman and Shapiro
Am. J. Psychiatry 1998;155:4-11.
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Progress in Psychiatry- First of Two Parts
Michels and Marzuk
NEJM 1993;329:552-560.
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