MORTALITY OF ELDERLY PATIENTS WITH PSYCHIATRIC-DISORDERS

Objective: The goal of this study was to evaluate the impact of common late-life mental disorders on the life expectancy and causes of death of older psychiatric patients. Method: The study population consisted of 809 older psychiatric patients who met DSM-III-R criteria for orga nic mental disorders, mood disorders, or psychotic disorders and who w ere discharged after a comprehensive multidisciplinary evaluation and acute inpatient treatment for their behavioral disorders. Dates and ca uses of death during a 5.75-year follow-up period were provided by the Pennsylvania Department of Health. Univariate and multivariate surviv al procedures were used to compare the survival rates of the three gro ups to each other and to a reference population of Pennsylvania reside nts. Causes of death were also tabulated according to ICD-9-CM and com pared across the groups. Results: Age, gender, race, and medical cobmo rbidity made significant independent contributions to survival. When t hese variables were controlled, the survival of patients with organic mental disorders was less than half of that for patients with mood or psychotic disorders. However, all three groups experienced higher rate s of mortality than the reference population, with standardized mortal ity ratios of 1.5 to 2.5. Deaths occurred from the usual spectrum of n atural causes, with the exception that patients with mood disorders we re more likely to have died from disorders of the digestive system and suicide. Conclusions: The mental disorders of late life have a signif icant negative impact on the survival of older psychiatric patients.