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Reducing all-cause mortality among patients with psychiatric disorders: a population-based study
Steve Kisely1, Neil Preston, Jianguo Xiao
1Department of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Australia. s.kisely@uq.edu.au
Summary
Compulsory community treatment orders may lower mortality in psychiatric patients. Increased healthcare access may explain reduced deaths from physical illnesses, but further research is needed.
Area of Science:
- Psychiatry
- Public Health
- Epidemiology
Background:
- Patients with psychiatric disorders experience 10x more preventable deaths from physical conditions than suicide.
- Investigated the impact of compulsory community treatment orders on all-cause mortality in psychiatric patients.
Purpose of the Study:
- To determine if community treatment orders reduce all-cause mortality in individuals with psychiatric disorders.
- To analyze the impact on 1-, 2-, and 3-year all-cause mortality.
Main Methods:
- Population-based survival analysis of an inception cohort in Western Australia (1997-2008).
- Used matched controls and Cox regression to adjust for demographic and clinical factors.
- Primary outcome: 2-year all-cause mortality; secondary outcomes: 1- and 3-year mortality.
Main Results:
- Community treatment orders were associated with significantly lower all-cause mortality (HR 0.62 at 2 years).
- Reduced mortality was most pronounced for physical illnesses (cancer, cardiovascular disease).
- This association diminished after adjusting for increased community psychiatric service contact.
Conclusions:
- Community treatment orders may reduce mortality in psychiatric patients, potentially through increased healthcare engagement.
- The role of uncontrolled confounding factors requires further investigation.
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