A1 Refereed original research article in a scientific journal
Temporal trends in mortality and associated factors among persons with mental disorders : A register-based cohort study
Authors: Yang, Min; Lantta, Tella; Vahlberg, Tero; Anttila, Minna; Normand, Sharon-Lise; Välimäki, Maritta
Publisher: Elsevier
Publication year: 2024
Journal: Psychiatry Research
Journal name in source: Psychiatry research
Journal acronym: Psychiatry Res
Article number: 116065
Volume: 339
ISSN: 0165-1781
eISSN: 1872-7123
DOI: https://doi.org/10.1016/j.psychres.2024.116065
Web address : https://doi.org/10.1016/j.psychres.2024.116065
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/457266429
Abstract
This study aims to examine 20-year temporal trends in all-cause mortality among psychiatric patients and investigating impacts of risk factors on the time trends based on 218,703 Finnish adults with mental disorders who were discharged from 87 psychiatric hospitals between 1 Jan 1995 and 31 Dec 2014. The age-period-cohort analysis of Poisson model with random hospital effects estimated temporal trends in death rate and associated factors at individual, healthcare system, and society levels, following the WHO multilevel intervention framework model for six major psychiatric diagnosis. The adjusted annual mortality declined by 2.2 % annually (RR: 0.978 [95 % CI 0.976-0.980]) for all individuals, and by 2.8 % after adjusting for all risk factors, with varied decreasing rate between 2.0 % and 3.6 % by diagnosis. Individual level factors accounted for the declining rate by 54.5 % for all patients, with the highest impact on patients with personality disorders, followed by patients with affective disorders and patients with schizophrenia. Identified declining trends and associated factors which are preventable and modifiable for individuals with specific psychiatric diagnosis may lead to develop targeted service and intervention strategies in bringing down mortality further for the population.
This study aims to examine 20-year temporal trends in all-cause mortality among psychiatric patients and investigating impacts of risk factors on the time trends based on 218,703 Finnish adults with mental disorders who were discharged from 87 psychiatric hospitals between 1 Jan 1995 and 31 Dec 2014. The age-period-cohort analysis of Poisson model with random hospital effects estimated temporal trends in death rate and associated factors at individual, healthcare system, and society levels, following the WHO multilevel intervention framework model for six major psychiatric diagnosis. The adjusted annual mortality declined by 2.2 % annually (RR: 0.978 [95 % CI 0.976-0.980]) for all individuals, and by 2.8 % after adjusting for all risk factors, with varied decreasing rate between 2.0 % and 3.6 % by diagnosis. Individual level factors accounted for the declining rate by 54.5 % for all patients, with the highest impact on patients with personality disorders, followed by patients with affective disorders and patients with schizophrenia. Identified declining trends and associated factors which are preventable and modifiable for individuals with specific psychiatric diagnosis may lead to develop targeted service and intervention strategies in bringing down mortality further for the population.
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