Mortality of patients with functional psychiatric illnesses during inpatient treatment

Data from 7 psychiatric hospitals with defined catchment areas were analysed. 8927 episodes of treatment in patients with functional psychiatric disorder were recorded within 30 months (mean age 43.4 +/- 16.6 years; 41.2% male patients). During their stay in hospital 51 patients died, 31 from natural causes and 20 by suicide, compared to 12 deaths expected from the mortality rates of the general population. Standardised mortality ratios (SMRs) were calculated for the different diagnostic and age groups. In the whole population mortality from all causes (SMR 4.27, p < 0.001), as well as from natural causes (SMR 2.6 < 0.01) were significantly raised. Risks were highest in patients with schizophrenia (SMR for all causes of death 6.6, p < 0.001). Mortality from natural causes was significantly elevated in schizophrenia and related disorders. Furthermore, a high level of excess mortality mainly due to suicide was established in patients aged under 45 years (SMR 12.2, p < 0.001). Cardiovascular disorders were the most frequent causes of natural death. Our data substantiate a significantly elevated mortality risk due to natural and unnatural death of patients hospitalised for acute mental illness. Although the causative factors have not yet been fully clarified, prophylactic measures with regard to medical care as well as suicide prevention should be intensified in psychiatric hospitals.