EXCESS MORTALITY OF PSYCHIATRIC-INPATIENTS IN TAIWAN

The 6-year mortality rate of a nation-wide cohort of Taiwanese psychia tric inpatients admitted during the 1-year period from 1987 to 1988 wa s examined via record linkage. The psychiatric care system in Taiwan i s mainly hospital-based, Of the 13 385 patients studied (9309 men and 4076 women), 2039 (1720 men and 319 women) had died by the end of 1993 , The standardized mortality ratio (SMR) in this sample (3.10 for men and 4.83 for women) was as high as those reported in western industria lized countries during the pre-deinstitutionalization era. We also exa mined the relationship between the excess mortality of patients and ag e, sex, causes of death, diagnostic categories, and length of hospital stay. In general, the SMR was greatest for the youngest age group, wo men, unnatural deaths, substance use disorders, and in the first year after admission. Although the main cause for the excess mortality was unnatural deaths, there was also an excess mortality due to natural ca uses across all diagnostic categories. Several recommendations for the improvement of psychiatric care in Taiwan are made on the basis of th ese findings.