Mental disorders and total mortality after 20 years in an adult general population sample
Mental disorders and total mortality after 20 years in an adult general population sample
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DOI：
10.1192/j.eurpsy.2020.27
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发表时间：
2020-01-01
影响因子：
7.8
通讯作者：
Meyer, Christian
中科院分区：
文献类型：
--
作者：
John, Ulrich;Rumpf, Hans-Juergen;Meyer, Christian
背景。关于精神障碍与总死亡率之间关系的一般人口数据很少。目的是分析一生中精神障碍、单一物质使用、情绪、焦虑、躯体形式或饮食障碍的数量，以及治疗使用是否可以预测普通成年人20年后的死亡时间。我们使用了综合国际诊断访谈的数据，其中包括DSM-IV对物质使用、情绪、焦虑、躯体形态和饮食失调的诊断，样本为1996年德国18-64岁的4,075名居民。20年后，使用公共死亡率数据库确定了4028名研究参与者的死亡率。Cox比例风险模型应用于访谈前生活中任何时间存在的疾病。数据显示，精神障碍（三种或三种以上；风险比为1.4；95%可信区间[CI]为1.1-1.9）和单一障碍（酒精依赖、心境恶劣、伴有旷野恐怖症的恐慌症和忧郁症）的风险比（HR）增加，参照组为未患任何精神障碍的研究参与者，并根据年龄、性别和受教育程度进行了调整。在一生中患有任何精神障碍的个体中，因精神障碍而住院治疗的HR （2.2; CI 1.6-3.0）高于未接受任何精神障碍治疗的HR。在这个普通人群中的成年人样本中，三种或三种以上的精神障碍、酒精依赖、情绪恶劣、广场恐怖症的恐慌症和疑病症与过早死亡有关。
Background. General population data on associations between mental disorders and total mortality are rare. The aim was to analyze whether the number of mental disorders, single substance use, mood, anxiety, somatoform or eating disorders during the lifetime and whether treatment utilization may predict time to death 20 years later in the general adult population.Methods. We used data from the Composite International Diagnostic Interview, which includes DSM-IV diagnoses for substance use, mood, anxiety, somatoform, and eating disorders, for a sample of 4,075 residents in Germany who were 18-64 years old in 1996. Twenty years later, mortality was ascertained using the public mortality database for 4,028 study participants. Cox proportional hazards models were applied for disorders that existed at any time in life before the interview.Results. The data revealed increased hazard ratios (HRs) for number of mental disorders (three or more; HR 1.4; 95% confidence interval [CI] 1.1-1.9) and for single disorders (alcohol dependence, dysthymia, panic disorder with agoraphobia, and hypochondriasis), with the reference group being study participants who had not suffered from any of the mental disorders analyzed and with adjustments made for age, sex, and education. Among individuals with any mental disorder during their lifetimes, having been an inpatient in treatment for a mental disorder was related to a higher HR (2.2; CI 1.6-3.0) than was not having been in any treatment for a mental disorder.Conclusions. In this sample of adults in the general population, three or more mental disorders, alcohol dependence, dysthymia, panic disorder with agoraphobia, and hypochondriasis were related to premature death.