IS DEATH FROM NATURAL CAUSES STILL EXCESSIVE IN PSYCHIATRIC-PATIENTS - A FOLLOW-UP OF 1593 PATIENTS WITH MAJOR AFFECTIVE-DISORDER
IS DEATH FROM NATURAL CAUSES STILL EXCESSIVE IN PSYCHIATRIC-PATIENTS - A FOLLOW-UP OF 1593 PATIENTS WITH MAJOR AFFECTIVE-DISORDER
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DOI：
10.1097/00005053-198711000-00005
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发表时间：
1987-11-01
影响因子：
1.9
通讯作者：
NASRALLAH, A
中科院分区：
文献类型：
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作者：
BLACK, DW;WINOKUR, G;NASRALLAH, A
对1593名患有严重情感障碍的爱荷华州人进行的随访显示，与年龄和性别匹配的普通人群相比，原发性和继发性抑郁症以及双相抑郁症的非自然原因导致的死亡率过高，而躁狂症则没有。在患有继发性单相抑郁症和双相抑郁症的妇女以及同时患有器质性精神障碍或严重内科疾病的躁狂症患者（男女合计）中发现了过多的自然死亡。在没有这些条件的情况下，自然死亡并不过分。我们的结论是，过多的自然死亡报告精神病患者是由于复杂的身体疾病，而不是原发性精神疾病本身，而过多的非自然死亡是由于精神疾病。此外，患有精神病的人在出现复杂的身体疾病时可能更经常地被转诊住院。最后，我们得出结论，原发性和继发性单相抑郁症患者的死亡率模式相似，但双相患者的非自然死亡风险低于单相患者。
A follow-up of 1593 Iowans with major affective disorder showed excessive mortality from unnatural causes in primary and secondary depression, and bipolar depression, but not mania, compared with age- and sex-matched controls from the general population. Excessive death from natural causes was found in women with secondary unipolar depression and bipolar depression and in manics (men and women combined) who had concurrent organic mental disorders or serious medical illnesses. Natural death was not excessive in the absence of these conditions. We conclude that excessive natural death reported in psychiatric patients is due to complicating physical disorders and not to the primary psychiatric disorder per se, whereas excessive unnatural death is due to the psychiatric disorder. Also, psychiatrically ill persons are probably referred for hospitalization more frequently when complicating physical disorders are present. Finally, we conclude that mortality patterns were similar in patients with primary and secondary unipolar depression, but bipolar patients were at lower risk for unnatural death than were unipolar patients.