Mortality in first-contact psychosis patients in the UK: a cohort study

The excess mortality following first-contact psychosis is well recognized. However, the causes of death in a complete incidence cohort and mortality patterns over time compared with the general population are unknown. All 2723 patients who presented for the first time with psychosis in three defined...

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Bibliographic Details
Published in:Psychological medicine 2012-08, Vol.42 (8), p.1649-1661
Main Authors: Dutta, R., Murray, R. M., Allardyce, J., Jones, P. B., Boydell, J. E.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Biological and medical sciences
Bipolar Disorder - mortality
Bipolar disorders
Cause of Death - trends
Cohort analysis
Cohort Studies
Confidence intervals
Death
Death Certificates
Female
First time
Humans
Incidence
Kaplan-Meier Estimate
Male
Medical sciences
Mental disorders
Mental health care
Middle Aged
Mood disorders
Mortality
Mortality - trends
Neoplasms - mortality
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychosis
Psychotic Disorders - mortality
Risk assessment
Rural Population
Schizophrenia
Schizophrenia - mortality
Sex Distribution
Suicide - statistics & numerical data
United Kingdom - epidemiology
Urban Population
Young Adult
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Description
Summary:The excess mortality following first-contact psychosis is well recognized. However, the causes of death in a complete incidence cohort and mortality patterns over time compared with the general population are unknown. All 2723 patients who presented for the first time with psychosis in three defined catchment areas of the U.K. in London (1965-2004, n=2056), Nottingham (1997-1999, n=203) and Dumfries and Galloway (1979-1998, n=464) were traced after a mean of 11.5 years follow-up and death certificates were obtained. Data analysis was by indirect standardization. The overall standardized mortality ratio (SMR) for first-contact psychosis was 184 [95% confidence interval (CI) 167-202]. Most deaths (84.2%, 374/444) were from natural causes, although suicide had the highest SMR (1165, 95% CI 873-1524). Diseases of the respiratory system and infectious diseases had the highest SMR of the natural causes of death (232, 95% CI 183-291). The risk of death from diseases of the circulatory system was also elevated compared with the general population (SMR 139, 95% CI 117-164) whereas there was no such difference for neoplasms (SMR 111, 95% CI 86-141). There was strong evidence that the mortality gap compared with the general population for all causes of death (p
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291711002807