scholarly journals Adolescent psychiatric in-patients

2000 ◽  
Vol 176 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Ellen Kjelsberg
Keyword(s):  
Anxiety Disorder ◽  
Mental Disorder ◽  
Record Linkage ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Mortality Rates ◽  
Psychiatric Diagnoses ◽  
Organic Mental Disorder ◽  
Standardised Mortality Ratios ◽  
Almost All

BackgroundResearch has demonstrated increased mortality rates in adolescent psychiatric in-patients.AimsTo investigate this excess mortality by calculating standardised mortality ratios (SMRs) relative to cause of death, diagnosis, cohort and age.MethodA nationwide Norwegian sample of 1095 former adolescent psychiatric in-patients were followed up 15–33 years after first hospitalisation by record linkage to the National Death Cause Registry.ResultsThe SMR was significantly increased for almost all causes of death investigated. In males, all psychiatric diagnoses had significantly increased SMRs, whereas in females, organic mental disorder, anxiety disorder and affective disorder had non-significantly increased SMRs. The SMR was significantly elevated for all age-spans and cohorts investigated.ConclusionsA broad prevention strategy is needed to combat the increased mortality rates found in adolescent psychiatric in-patients.

scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

2020 ◽  
Author(s):  
Karin Modig ◽  
Anders Ahlbom ◽  
Marcus Ebeling
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
Death Rates ◽  
Excess Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

scholarly journals O7.1. ASSOCIATION BETWEEN PATTERNS OF COMORBID MENTAL DISORDERS AND MORTALITY-RELATED ESTIMATES. A NATIONWIDE, REGISTER-BASED COHORT STUDY BASED ON 7.5 MILLION INDIVIDUALS LIVING IN DENMARK

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Oleguer Plana-Ripoll ◽  
Natalie Momen ◽  
Nanna Weye ◽  
John McGrath
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Substance Use Disorders ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Neurotic Disorders ◽  
Comorbid Mental Disorders

Abstract Background Comorbidity within mental disorders is common – individuals with one type of mental disorder are at increased risk of subsequently developing other types of disorders. Previous studies are usually restricted to temporally-ordered pairs of disorders. While more complex patterns of comorbidity have been described (e.g. internalizing and externalizing disorders), there is a lack of detailed information on the nature of the different sets of comorbid mental disorders. Additionally, mental disorders are associated with premature mortality, and people with two or more types of mental disorders have a shorter life expectancy compared to those with exactly one type of mental disorder. The aims of this study were to: (a) describe the prevalence and demographic correlates of combinations of mental disorders; and (b) estimate the excess mortality for each of these combinations. Methods We conducted a population-based cohort study including all 7,505,576 persons living in Denmark in 1995–2016. Information on mental disorders and mortality was obtained from national registers. First, we described the most common combinations of mental disorders defined by the ICD-10 F-subchapters (substance use disorders, schizophrenia spectrum disorder, mood disorders, neurotic disorders, etc.). Then, we investigated excess mortality using mortality rate ratios (MRRs) and differences in life expectancy after disease diagnosis compared to the general population of same sex and age. Results At the end of the 22-year observation, 6.2% individuals were diagnosed with exactly one type of disorder, 2.7% with exactly two, 1.1% with exactly three, and 0.5% with four or more types. The most prevalent mental disorders were neurotic disorders (4.6%) and mood disorders (3.8%), even when looking particularly at persons with a specific number of disorders (exactly one type, exactly two types, etc.). We observed 616 out of 1,024 possible sets of disorders, but the 52 most common sets (with at least 1,000 individuals each) represented 92.8% of all persons with diagnosed mental disorders. Mood and/or neurotic disorders, alone or in combination with other disorders, were present in 64.8% of individuals diagnosed with mental disorders. People with all combinations of mental disorders had higher mortality rates than those without any mental disorder diagnosis, with MRRs ranging from 1.10 (95% CI 0.67 – 1.84) for the two-disorder set of developmental-behavioral disorders to 5.97 (95% CI 5.52 – 6.45) for the three-disorder set of schizophrenia-neurotic-substance use disorders. Additionally, any combination of mental disorders was associated with shorter life expectancies compared to the general population, with estimates ranging from 5.06 years [95% CI 5.01 – 5.11] for the one-disorder set of organic disorders to 17.46 years [95% CI 16.86 – 18.03] for the three-disorder set of schizophrenia-personality-substance use disorders. Discussion Within those with mental disorders, approximately 2 out of 5 had two more types of mental disorders. Our study provides prevalence estimates of the most common sets of mental disorders – mood disorders (e.g. depression) and neurotic disorders (e.g. anxiety) commonly co-occur, and contribute to many different sets of comorbid mental disorders. The association between mental disorders comorbidity and mortality-related estimates revealed the prominent role of substance use disorders with respect to both elevated mortality rates and reduced life expectancies. Substance use disorders are relatively common, and these disorders often feature in sets of mental disorders. In light of the substantial contribution to premature mortality, efforts related to the ‘primary prevention of secondary comorbidity’ warrant added scrutiny.

Bereavement and heart disease

1971 ◽  
Vol 3 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Bernard Benjamin
Keyword(s):  
Heart Disease ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Middle Age ◽  
Mortality Rates ◽  
Age Group ◽  
General State ◽  
Older Person ◽  
Statistical Review ◽  
Registrar General

Ever since the Registrar General began to give mortality rates for different marital condition groups, it has been observed that, in every age group and for both sexes, the widowed have higher mortality rates than the married. In his 1959 Annual Statistical Review, the Registrar General made some analysis of this differential in terms of causes of death. The excess mortality as compared with the married appeared to affect the diseases listed in Table 1. The Registrar General's commentary asked ‘Leaving aside the question of possibility of error (in statements of marital condition) is it possible that the effect of death of a spouse is such as to increase the likelihood of death in the surviving member of the partnership? Here the basis of discussion has little factual support but it seems right to suppose that in the period immediately following bereavement the general state of ‘shock’ indeed is such as to increase likelihood of death. In the majority of young and middle-age widowed persons, however, this period passes and adjustment takes place, often followed by remarriage. There will be some selection here similar in many respects to that affecting the decision whether single persons should marry. With the older person, however, adjustment is more difficult to attain, remarriage is less common and the surviving partner, particularly the man, may live under relatively unfavourable conditions.’

scholarly journals The Enduring Association between Education and Mortality

2011 ◽  
Vol 76 (6) ◽  
pp. 913-934 ◽  
Author(s):  
Richard Miech ◽  
Fred Pampel ◽  
Jinyoung Kim ◽  
Richard G. Rogers
Keyword(s):  
United States ◽  
Health Disparities ◽  
Causes Of Death ◽  
The United States ◽  
Mortality Rates ◽  
Social Forces ◽  
Educational Disparities ◽  
Fundamental Cause ◽  
Almost All ◽  
Over Time

This article examines how educational disparities in mortality emerge, grow, decline, and disappear across causes of death in the United States, and how these changes contribute to the enduring association between education and mortality over time. Focusing on adults age 40 to 64 years, we first examine the extent to which educational disparities in mortality persisted from 1989 to 2007. We then test the fundamental cause prediction that educational disparities in mortality persist, in part, by shifting to new health outcomes over time. We focus on the period from 1999 to 2007, when all causes of death were coded to the same classification system. Results indicate (1) substantial widening and narrowing of educational disparities in mortality across causes of death, (2) almost all causes of death with increasing mortality rates also had widening educational disparities, and (3) the total educational disparity in mortality would be about 25 percent smaller today if not for newly emergent and growing educational disparities since 1999. These results point to the theoretical and policy importance of identifying social forces that cause health disparities to widen over time.

Excess Mortality Among 10-Year Survivors of Classical Hodgkin Lymphoma in Adolescents and Young Adults

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 694-694
Author(s):  
Ana Xavier ◽  
Luciano J. Costa
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Cardiovascular Diseases ◽  
Hodgkin Lymphoma ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Mortality Rates ◽  
Classical Hodgkin Lymphoma

Background: Adolescents and young adults (AYA) surviving classical Hodgkin Lymphoma (cHL) commonly face significant treatment-related morbidity that can result in premature death. It is not known if changes in therapy in recent years have resulted in reduction of excess mortality among long-term survivors of AYA-cHL. Methods: We used data from the National Cancer Institute's Surveillance Epidemiology and End Results program (SEER-18) to determine the excess mortality rate (EMR) for 10-year survivors of cHL. We included patients age 15-39 years diagnosed with cHL as first malignant neoplasm from 1993 until 2003. Cases reported from death certificates or autopsy only were excluded. Follow up was updated at the end of 2013. EMR was calculated using the difference between the observed mortality in the cohort of interest and the adjusted expected mortality among age, gender and race-matched individuals in the general population. Results: A total of 6,480 cases of cHL were included in the analysis with median follow up of 42.5 months. Median age of patients was 27 years at the time of diagnosis, 3,172 (48.9%) were male, 4,405 (68%) had stage I or II, 1,750 (27%) had stage III or IV, and in 325 (5%) cases stage was not available. Most patients were non-Hispanic white (4,783, 73.8%), 761 (11.7%) Hispanic, 615 (9.5%) non-Hispanic black, 276 (4.3%) other ethnicity, and 45 (0.7%) unknown. Five thousand and sixty eight (78.2%) had nodular sclerosis cHL, 616 (9.5%) had mixed-cellularity cHL, 606 (9.4%) had cHL non-otherwise specified, 153 (2.4%) had lymphocyte-rich cHL, and 37 (0.57%) had lymphocyte depleted cHL. The 15-year, 18-year, and 20-year EMR for 10-year survivors was 2.19% (95% C.I, 1.69%-2.86%), 3.48% (95% C.I. 2.57%-4.64%) and 4.07% (95% C.I. 2.53%-6.52%), respectively. EMR among 10 year AYA cHL survivors with diagnosis between 1993 and 2003 was substantially improved when compared to a similar cohort of 5,870 survivors with diagnosis between 1973 and 1992 (Figure 1). EMR at 15 and 18 years of diagnosis was higher among survivors of stage III-IV cHL than among survivors of stages I-II (Figure 2a), and higher at 15 years among males than female survivors (Figure 2b). Use of radiation therapy for early stage disease did not seem to affect the risk of excess mortality among 10-year survivors (Table). Causes of death were similar for stages I-II vs. stages III-IV. Most common causes of death were second malignancy (27.2%), cardiovascular disease (19%), and Hodgkin lymphoma (18.5%). Among male survivors there was a higher proportion of deaths due to cardiovascular disease (23.7% vs. 11.5%, p <0.038). Conclusion: Excess mortality rates for 10-year survivors of AYA-cHL has decreased with adoption of less toxic therapies. However, mortality rates continue high for several years for long term AYA HL survivors, mainly due to second malignancies and cardiovascular diseases. Less toxic therapies, control of cardiovascular diseases and implementation of cancer prevention programs for survivors of AYA-cHL are needed. Table. Table. Disclosures Costa: Sanofi: Honoraria, Research Funding.

Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients

2017 ◽  
Vol 47 (8) ◽  
pp. 1489-1499 ◽  
Author(s):  
J. Kask ◽  
M. Ramklint ◽  
N. Kolia ◽  
D. Panagiotakos ◽  
A. Ekbom ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Cox Regression ◽  
Somatoform Disorders ◽  
Psychiatric Diagnoses ◽  
Co Morbidity ◽  
Significant Difference

BackgroundAnorexia nervosa (AN) is a psychiatric disorder with high mortality.MethodA retrospective register study of 609 males who received hospitalized care for AN in Sweden between 1973 and 2010 was performed. The standardized mortality ratios (SMRs) and Cox regression-derived hazard ratios (HRs) were calculated as measures of mortality. The incidence rate ratios (IRRs) were calculated to compare the mortality rates in patients with AN and controls both with and without psychiatric diagnoses.ResultsThe SMR for all causes of death was 4.1 [95% confidence interval (CI) 3.1–5.3]. For those patients with psychiatric co-morbidities, the SMR for all causes of death was 9.1 (95% CI 6.6–12.2), and for those without psychiatric co-morbidity, the SMR was 1.6 (95% CI 0.9–2.7). For the group of patients with alcohol use disorder, the SMR for natural causes of death was 11.5 (95% CI 5.0–22.7), and that for unnatural causes was 35.5 (95% CI 17.7–63.5). The HRs confirmed the increased mortality for AN patients with psychiatric co-morbidities, even after adjusting for confounders. The IRRs revealed no significant difference in mortality patterns between the AN patients with psychiatric co-morbidity and the controls with psychiatric diagnoses, with the exceptions of alcohol use disorder and neurotic, stress-related and somatoform disorders, which seemed to confer a negative synergistic effect on mortality.ConclusionMortality in male AN patients was significantly elevated compared with the general population among only the patients with psychiatric co-morbidities. Specifically, the presence of alcohol and other substance use disorders was associated with more profound excess mortality.

scholarly journals Mental disorder and long-term risk of mortality: 41 years of follow-up of a population sample in Stockholm, Sweden

2015 ◽  
Vol 25 (4) ◽  
pp. 384-392 ◽  
Author(s):  
A. Lundin ◽  
K. Modig ◽  
J. Halldin ◽  
A. C. Carlsson ◽  
P. Wändell ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Health Behaviour ◽  
Alcohol Use Disorder ◽  
Population Sample ◽  
Mortality Rates ◽  
Psychiatric Diagnoses ◽  
Somatic Health ◽  
Risk Of Mortality

Background.An increased mortality risk associated with mental disorder has been reported for patients, but there are few studies are based on random samples with interview-based psychiatric diagnoses. Part of the increased mortality for those with mental disorder may be attributable to worse somatic health or hazardous health behaviour – consequences of the disorder – but somatic health information is commonly lacking in psychiatric samples. This study aims to examine long-term mortality risk for psychiatric diagnoses in a general population sample and to assess mediation by somatic ill health and hazardous health behaviour.Method.We used a double-phase stratified random sample of individuals aged 18–65 in Stockholm County 1970–1971 linked to vital records. First phase sample was 32 186 individuals screened with postal questionnaire and second phase was 1896 individuals (920 men and 976 women) that participated in a full-day examination (participation rate 88%). Baseline examination included both a semi-structured interview with a psychiatrist, with mental disorders set according to the 8th version of the International Classification of Disease (ICD-8), and clinical somatic examination, including measures of body composition (BMI), hypertension, fasting blood glucose, pulmonary function and self-reported tobacco smoking. Information on vital status was obtained from the Total Population Register for the years 1970–2011. Associations with mortality were studied with Cox proportional hazard analyses.Results.A total of 883 deaths occurred among the participants during the 41-year follow-up. Increased mortality rates were found for ICD-8 functional psychoses (hazard ratio, HR = 2.22, 95% confidence interval (95% CI): 1.15–4.30); psycho-organic symptoms (HR = 1.94, 95% CI: 1.31–2.87); depressive neuroses (HR = 1.71, 95% CI: 1.23–2.39); alcohol use disorder (HR = 1.91, 95% CI: 1.40–2.61); drug dependence (HR = 3.71, 95% CI: 1.80–7.65) and psychopathy (HR = 2.88, 95% CI: 1.02–8.16). Non-participants (n = 349) had mortality rates similar to participants (HR = 0.98, 95% CI: 0.81–1.18). In subgroup analyses of those with psychoses, depression or alcohol use disorder, adjusting for the potential mediators smoking and pulmonary function, showed only slight changes in the HRs.Conclusions.This study confirms the increased risk of mortality for several psychiatric diagnoses in follow-up studies on American, Finnish and Swedish population-based samples. Only a small part of the increased mortality hazard was attributable to differences in somatic health or hazardous health behaviour measured at baseline.

scholarly journals Excess mortality among people with podoconiosis: secondary analysis of two Ethiopian cohorts

2020 ◽  
Vol 114 (12) ◽  
pp. 1035-1037
Author(s):  
Hannah Masraf ◽  
Temesgen Azemeraw ◽  
Meseret Molla ◽  
Christopher Iain Jones ◽  
Stephen Bremner ◽  
...  
Keyword(s):  
General Population ◽  
Surveillance System ◽  
Excess Mortality ◽  
Secondary Analysis ◽  
Demographic Surveillance System ◽  
Northern Ethiopia ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Standardised Mortality Ratios ◽  
Patients Experience

Abstract Background While morbidity attributable to podoconiosis is relatively well studied, its pattern of mortality has not been established. Methods We compared the age-standardised mortality ratios (SMRs) of two datasets from northern Ethiopia: podoconiosis patients enrolled in a 1-y trial and a Health and Demographic Surveillance System cohort. Results The annual crude mortality rate per 1000 population for podoconiosis patients was 28.7 (95% confidence interval [CI] 17.3 to 44.8; n=663) while that of the general population was 2.8 (95% CI 2.3 to 3.4; n=44 095). The overall SMR for the study period was 6.0 (95% CI 3.6 to 9.4). Conclusions Podoconiosis patients experience elevated mortality compared with the general population and further research is required to understand the reasons.

scholarly journals Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eve Robinson ◽  
Lawrence Lee ◽  
Leslie F. Roberts ◽  
Aurelie Poelhekke ◽  
Xavier Charles ◽  
...  
Keyword(s):  
Central African Republic ◽  
Causes Of Death ◽  
Maternal Mortality Ratio ◽  
Mortality Rates ◽  
Population Based ◽  
Access To Healthcare ◽  
Mortality Data ◽  
Humanitarian Emergency ◽  
The World ◽  
Mortality Survey

Abstract Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.

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