Mortality of patients with mood disorders: follow-up over 34–38 years
Background: All follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less reproducible increased mortality from other causes. The reported rates by gender, disorder type and treatment are more variable. Methods: Hospitalised...
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| Published in: | Journal of affective disorders Vol. 68; no. 2; pp. 167 - 181 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Amsterdam
Elsevier B.V
01-04-2002
Elsevier |
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| Online Access: | Get full text |
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| Abstract | Background: All follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less reproducible increased mortality from other causes. The reported rates by gender, disorder type and treatment are more variable.
Methods: Hospitalised affective disordered patients (
n=406) were followed prospectively for 22 years or more. Later, mortality was assessed for 99% of them at which time 76% had died.
Results: Standardised Mortality Rates (observed deaths/expected deaths) for patients were elevated especially for suicide and circulatory disorders in both men and women. Women actually had higher suicide rates but that did not take into account the twofold increase in general population rates for men. Unipolar patients had significantly higher rates of suicide than bipolar Is or IIs. In all groups long term medication treatment with antidepressants alone or with a neuroleptic, or with lithium in combination with antidepressants and/or neuroleptics significantly lowered suicide rates even though the treated were more severely ill. Although at the age of onset the suicide rates were most elevated, from ages 30 to 70 the rates were remarkably constant despite the different courses of illness.
Limitations: The patients were identified as inpatients and followed prospectively. The treatments were uncontrolled and are not quantifiable but were documented during the follow-up.
Conclusions: Men and women hospitalised for affective disorders have elevated mortality rates from suicide and circulatory disorders. Unipolars have higher suicide rates than bipolar Is or IIs. Long term medication treatment lowers the suicide rates, despite the fact that it was the more severely ill who were treated. |
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| AbstractList | Background: All follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less reproducible increased mortality from other causes. The reported rates by gender, disorder type and treatment are more variable.
Methods: Hospitalised affective disordered patients (
n=406) were followed prospectively for 22 years or more. Later, mortality was assessed for 99% of them at which time 76% had died.
Results: Standardised Mortality Rates (observed deaths/expected deaths) for patients were elevated especially for suicide and circulatory disorders in both men and women. Women actually had higher suicide rates but that did not take into account the twofold increase in general population rates for men. Unipolar patients had significantly higher rates of suicide than bipolar Is or IIs. In all groups long term medication treatment with antidepressants alone or with a neuroleptic, or with lithium in combination with antidepressants and/or neuroleptics significantly lowered suicide rates even though the treated were more severely ill. Although at the age of onset the suicide rates were most elevated, from ages 30 to 70 the rates were remarkably constant despite the different courses of illness.
Limitations: The patients were identified as inpatients and followed prospectively. The treatments were uncontrolled and are not quantifiable but were documented during the follow-up.
Conclusions: Men and women hospitalised for affective disorders have elevated mortality rates from suicide and circulatory disorders. Unipolars have higher suicide rates than bipolar Is or IIs. Long term medication treatment lowers the suicide rates, despite the fact that it was the more severely ill who were treated. All follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less reproducible increased mortality from other causes. The reported rates by gender, disorder type and treatment are more variable. Hospitalised affective disordered patients (n=406) were followed prospectively for 22 years or more. Later, mortality was assessed for 99% of them at which time 76% had died. Standardised Mortality Rates (observed deaths/expected deaths) for patients were elevated especially for suicide and circulatory disorders in both men and women. Women actually had higher suicide rates but that did not take into account the twofold increase in general population rates for men. Unipolar patients had significantly higher rates of suicide than bipolar Is or IIs. In all groups long term medication treatment with antidepressants alone or with a neuroleptic, or with lithium in combination with antidepressants and/or neuroleptics significantly lowered suicide rates even though the treated were more severely ill. Although at the age of onset the suicide rates were most elevated, from ages 30 to 70 the rates were remarkably constant despite the different courses of illness. The patients were identified as inpatients and followed prospectively. The treatments were uncontrolled and are not quantifiable but were documented during the follow-up. Men and women hospitalised for affective disorders have elevated mortality rates from suicide and circulatory disorders. Unipolars have higher suicide rates than bipolar Is or IIs. Long term medication treatment lowers the suicide rates, despite the fact that it was the more severely ill who were treated. BACKGROUNDAll follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less reproducible increased mortality from other causes. The reported rates by gender, disorder type and treatment are more variable. METHODSHospitalised affective disordered patients (n=406) were followed prospectively for 22 years or more. Later, mortality was assessed for 99% of them at which time 76% had died. RESULTSStandardised Mortality Rates (observed deaths/expected deaths) for patients were elevated especially for suicide and circulatory disorders in both men and women. Women actually had higher suicide rates but that did not take into account the twofold increase in general population rates for men. Unipolar patients had significantly higher rates of suicide than bipolar Is or IIs. In all groups long term medication treatment with antidepressants alone or with a neuroleptic, or with lithium in combination with antidepressants and/or neuroleptics significantly lowered suicide rates even though the treated were more severely ill. Although at the age of onset the suicide rates were most elevated, from ages 30 to 70 the rates were remarkably constant despite the different courses of illness. LIMITATIONSThe patients were identified as inpatients and followed prospectively. The treatments were uncontrolled and are not quantifiable but were documented during the follow-up. CONCLUSIONSMen and women hospitalised for affective disorders have elevated mortality rates from suicide and circulatory disorders. Unipolars have higher suicide rates than bipolar Is or IIs. Long term medication treatment lowers the suicide rates, despite the fact that it was the more severely ill who were treated. |
| Author | Angst, F Clayton, P.J Stassen, H.H Angst, J |
| Author_xml | – sequence: 1 givenname: F surname: Angst fullname: Angst, F organization: Institute of Social and Preventive Medicine, Zurich University, Zurich, Switzerland – sequence: 2 givenname: H.H surname: Stassen fullname: Stassen, H.H organization: Zurich University Psychiatric Hospital, Lenggstrasse 31 Mail Box 68, 8029 Zurich, Switzerland – sequence: 3 givenname: P.J surname: Clayton fullname: Clayton, P.J organization: Santa Fé, NM, USA – sequence: 4 givenname: J surname: Angst fullname: Angst, J email: jangst@mailhost.unizh.ch organization: Zurich University Psychiatric Hospital, Lenggstrasse 31 Mail Box 68, 8029 Zurich, Switzerland |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13725359$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/12063145$$D View this record in MEDLINE/PubMed |
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| CODEN | JADID7 |
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| Snippet | Background: All follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less... All follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less reproducible... BACKGROUNDAll follow-up studies of causes of death in affective disordered patients have found they have markedly elevated suicide rates and a less... |
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| SubjectTerms | Adult and adolescent clinical studies Aged Biological and medical sciences Bipolar disorder Bipolar Disorder - diagnosis Bipolar Disorder - mortality Bipolar Disorder - psychology Cardiovascular Diseases - diagnosis Cardiovascular Diseases - mortality Cardiovascular Diseases - psychology Cause of Death Female Follow-Up Studies Gender Humans Male Medical sciences Miscellaneous Mood disorders Mood Disorders - diagnosis Mood Disorders - mortality Mood Disorders - psychology Mortality Prospective Studies Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Risk Assessment Sex Factors Suicide Suicide - statistics & numerical data Survival Analysis Switzerland - epidemiology Treatment Unipolar |
| Title | Mortality of patients with mood disorders: follow-up over 34–38 years |
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