19 Mar Marked Increase in Premature Mortality After First Psychiatric Admission
MedicalResearch.com Interview with:
Florian Walter MSc
Centre for Mental Health and Safety
University of Manchester, Manchester, England
Dr Roger Webb PhD and
Reader in Mental Health Epidemiology
Senior Postgraduate Research Tutor
Division of Psychology and Mental Health
Faculty of Biology, Medicine and Health
The University of Manchester
MedicalResearch.com: What is the background for this study?
Response: Mental disorders are associated with an elevated risk of premature mortality, and risk is especially heightened soon after discharge from inpatient psychiatric services. Previous studies have focused on single causes of death, whereas our study considered a comprehensive array of cause-specific mortality outcomes.
We analysed over 1.7 million Danish residents in our national interlinked registry study, which was conducted collaboratively by the Centre of Mental Health and Safety, University of Manchester, UK and the National Centre for Register-based Research, Aarhus University, Denmark. We compared the risk of dying from specific natural and unnatural causes of death among patients following their first discharge from inpatient psychiatric care versus people not admitted.
MedicalResearch.com: What are the main findings?
Response: Within a year of discharge, former psychiatric patients were 16 times more likely to die prematurely compared to individuals never admitted to inpatient psychiatric services. The first month post-discharge was the time period of highest relative risk for each cause of death examined. Comparing risk within a year post-discharge to longer term follow up, the risk was markedly elevated within the first year for most causes of death. The relative risk for unnatural death was greater than for natural death, with highest relative risks observed for suicide and alcohol-induced death. Patients diagnosed with alcohol or drug misuse disorders were at particularly elevated risk post-discharge.
MedicalResearch.com: What should readers take away from your report?
Response: Enhanced liaison between primary and secondary health services post-discharge, as well as early intervention programs for drug and alcohol misuse could substantially decrease the greatly elevated mortality risk among recently discharged psychiatric patients. Clinicians should ensure the safety of their patients by close monitoring, especially those with alcohol and drug misuse disorders.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Given that risk is markedly elevated across such a broad range causes of premature death, and especially so soon after discharge, further research is needed to understand the multiple mechanisms that are likely implicated.
Note: This was a collaborative study between the Universities of Manchester (UK) and Aarhus (Denmark)
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Last Updated on March 19, 2017 by Marie Benz MD FAAD