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Am J Psychiatry 1997; 154:1360-1368
Copyright © 1997 by American Psychiatric Association
Mortality of elderly patients with psychiatric disorders
GS Zubenko, BH Mulsant, RA Sweet, RE Pasternak and XM Tu
Department of Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, Pittsburgh, PA, USA.
OBJECTIVE: The goal of this study was to evaluate the impact of common
late-life mental disorders on the life expectancy and causes of death of
older psychiatric patients. METHOD: The study population consisted of 809
older psychiatric patients who met DSM-III-R criteria for organic mental
disorders, mood disorders, or psychotic disorders and who were discharged
after a comprehensive multidisciplinary evaluation and acute inpatient
treatment for their behavioral disorders. Dates and causes of death during
a 5.75-year follow-up period were provided by the Pennsylvania Department
of Health. Univariate and multivariate survival procedures were used to
compare the survival rates of the three groups to each other and to a
reference population of Pennsylvania residents. Causes of death were also
tabulated according to ICD-9-CM and compared across the groups. RESULTS:
Age, gender, race, and medical comorbidity made significant independent
contributions to survival. When these variables were controlled, the
survival of patients with organic mental disorders was less than half of
that for patients with mood or psychotic disorders. However, all three
groups experienced higher rates of mortality than the reference population,
with standardized mortality ratios of 1.5 to 2.5. Deaths occurred from the
usual spectrum of natural causes, with the exception that patients with
mood disorders were more likely to have died from disorders of the
digestive system and suicide. CONCLUSIONS: The mental disorders of late
life have a significant negative impact on the survival of older
psychiatric patients.
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