Mortality among discharged psychiatric patients in Finland

No comprehensive study has yet been made of mortality among psychiatric patients in Finland. According to studies conducted in other parts of the world, the mortality rates of psychiatric patients are higher than those of the general population. The study population here consisted of all patients discharged from psychiatric hospitals during the year 1988 (n = 22940). The register follow-up of these patients extended up to the year 1992. In the course of the follow-up a total of 3936 discharged psychiatric patients died (17.2%). The standardized mortality ratio (SMR) of the patients discharged from psychiatric hospitals was almost four times higher than that of the general population. The proportion of unnatural causes of death, including accidents in the young age groups and especially the much higher suicide SMR among young women, is a particularly striking finding. Natural causes of death were also more prevalent among the study population than in the general population, the major causes being acute myocardial infarction and unspecified pneumonia. The results of this study confirm previous findings of increased mortality among psychiatric patients compared to the general population. On the basis of this study one cannot, however, conclude that the reason for the high mortality rate would be premature discharge. More attention needs to be paid to the care of young patients and to supporting the patient during the transition from the hospital to community care.