Increased mortality among patients admitted with major psychiatric disorders: A register-based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia
Increased mortality among patients admitted with major psychiatric disorders: A register-based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia
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DOI：
10.4088/jcp.v68n0612
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发表时间：
2007-06-01
影响因子：
5.3
通讯作者：
Mortensen, Preben Bo
中科院分区：
文献类型：
--
作者：
Laursen, Thomas Munk;Munk-Olsen, Trine;Mortensen, Preben Bo
背景：与没有精神障碍的人相比，患有严重精神障碍的人的死亡率较高。然而，每种精神障碍的超额死亡率的程度不同，并且从未在基于人群的研究中检验过一级家庭成员患有精神障碍对死亡率的影响。目的：我们的目的是检查和比较精神分裂症、分裂情感性障碍、单相抑郁症或双相情感障碍入院后的死亡率，并检查精神病入院家族史对死亡率的影响。方法：我们建立了一项基于登记的队列研究1973 年 1 月 1 日或之后出生且在 15 岁生日时在丹麦出生的 550 万人。使用泊松回归通过生存分析估计死亡率比率。结果：单相抑郁症、双相情感障碍和分裂情感障碍与相同的超额死亡率模式相关。与其他 3 种疾病相比，精神分裂症的非自然原因死亡率较低，自然原因死亡率较高。精神病入院家族史与超额死亡率相关。结论：4种疾病患者均存在超额死亡率，但超额死亡率的模式并不相同。一级家庭成员中存在与精神障碍相关的超额死亡率，但这仅解释了与所检查的 4 种精神障碍相关的总体超额死亡率的一小部分。
Context: Persons suffering from severe mental disorder have an excess mortality compared to persons with no mental disorder. However, the magnitude of the excess mortality differs from one mental disorder to another, and the impact on mortality if a first-degree family member suffers from a mental disorder has never been examined in a population-based study.Objective: Our objective was to examine and compare mortality rates after admission with schizophrenia, schizoaffective disorder, unipolar depressive disorder, or bipolar affective disorder and to examine the impact of family history of psychiatric admission on mortality.Method: We established a register-based cohort study of 5.5 million persons born in Denmark who were alive on or born after January 1, 1973 and alive on their 15th birthday. Mortality rate ratios were estimated by survival analysis, using Poisson regression.Results: Unipolar depressive disorder, bipolar affective disorder, and schizoaffective disorder were associated with the same pattern of excess mortality. Schizophrenia had a lower mortality from unnatural causes of death and a higher mortality from natural causes compared to the 3 other disorders. Family history of psychiatric admission was associated with excess mortality.Conclusion: Patients suffering from the 4 disorders all had an excess mortality, but the pattern of excess mortality was not the same. There was an excess mortality associated with mental disorder in a first-degree family member, but this only explained a small part of the general excess mortality associated with the 4 mental disorders examined.