Mortality and associated characteristics of an adult population with mental disorders

Evidence shows that mentally ill persons among the general population die earlier than those without mental disease. Limitations of research include that epidemiological studies did not use modern standardized psychiatric diagnostic systems, and that detailed information about health risk behaviors are missing, particularly about tobacco smoking and alcohol consumption. Findings according to somatoform disorders are missing, and we lack knowledge about utilization of psychiatric care and other medical care with respect to mortality risks. Therefore, work that we did before includes one baseline survey of a random sample of 4,075 adults at age 18 to 64 in the general population of a German region in the year 1996. We published a second study about the mortality risks of those who had been diagnosed at baseline as ever having fulfilled the criteria of alcohol dependence in lifetime before compared to those without such a diagnosis. We concluded from this second study that the planned project will be feasible. Its aims include, first, to analyze mortality rates per specific diagnosis among three subgroups of the sample - individuals with substance use disorders, individuals with affective disorders, and individuals with somatoform disorders - 20 years after baseline. The second aim is to compare those those who are still alive with those have been deceased including time to death according to single characteristics of tobacco smoking and alcohol risk drinking. Third, we will analyze whether the same lifetime exposure to tobacco smoke with or without nicotine dependence is related to different mortality risks. Fourth, mortality risks among those with somatoform disorders are to be analyzed compared to those without. Fifth, utilization of psychiatric and further medical care will be analyzed among patients with single disorders. The work program includes the collection of vital status data, i. e. whether a single person has been deceased, and if, at which date. Causes of death are to be analyzed from death certificates. Work will particularly include address searches and publication of the data according to each single study aim.

Ziel des Projektes war, neue Erkenntnisse zu Sterbewahrscheinlichkeit und Lebensdauern bei Menschen mit psychiatrischen Erkrankungen im Vergleich zu Menschen ohne diese Erkrankungen zu liefern. Dabei sollten Suchtkrankheiten einen Fokus bilden. Zur Verfügung stand eine vor 20 Jahren untersuchte Zufallsstichprobe einer Erwachsenenbevölkerung in Norddeutschland. Für die Studienteilnehmer und -teilnehmerinnen waren psychiatrische Diagnosen mittels eines standardisierten Interviews erstellt worden. Nun bestand das Arbeitsprogramm darin, den Vitalstatus der Menschen in der Stichprobe zu bestimmen. Wir überprüften, ob und gegebenenfalls wann sie im Laufe der 20 Jahre gestorben sind. Für die Verstorbenen wurden die Todesbescheinigungen analysiert. Die Ergebnisse zeigen eine höhere Zahl an Verstorbenen unter Menschen mit einzelnen psychischen Störungen, insbesondere Suchterkrankungen, im Vergleich zu Menschen ohne diese Störungen. Die Datenanalysen zur sehr stark verkürzten Lebenszeit bei „schwerer" Abhängigkeit und bei Abstinenz von Alkohol zeigen eine besonders hohe Bedeutung der Befunde für Public Health, für ein Überdenken des Krankenversorgungssystems und für das Erfordernis von Prävention chronischer Krankheiten in Bevölkerungen, auch über psychische Störungen hinaus.