Sg. Kamara et al., PREVALENCE OF PHYSICAL ILLNESS AMONG PSYCHIATRIC-INPATIENTS WHO DIE OF NATURAL CAUSES, Psychiatric services, 49(6), 1998, pp. 788-793
Objective: The state psychiatric hospital is experiencing an increase
in medically sick and aging patients who die of natural causes while h
ospitalized. This study explored the ''medicalization'' of the state h
ospital by examining the prevalence of medical illness and its relatio
nship with psychiatric illness and age among state hospital psychiatri
c inpatients who died of natural causes-deaths that were not accidents
, homicides, or suicides. Methods: A total of 179 inpatients who died
of natural causes at Western State Hospital in Washington State betwee
n 1989 and 1994 were studied retrospectively through case file review.
Their demographic and institutional characteristics and psychiatric d
iagnoses were compared with those of others treated at the hospital (N
=9,258), The medical diagnoses of patients who died were analyzed by a
ge and psychiatric condition. Results: The patients who died were much
older than the other patients treated during the study period, Two-th
irds of those who died had organic mental disorders, mostly dementia,
whereas only a fifth of the other patients had these disorders, The pa
tients who died had a mean of eight physical illnesses, with a range f
rom none to 21, Circulatory and respiratory conditions were most preva
lent, affecting half to two-thirds of patients; these conditions had h
igh rates of comorbidity with organic mental disorders. Conclusions: T
he characteristics of the state hospital population and the services p
rovided are shifting in response to mental health reform and new polic
ies on patient self-determination, Increased emphasis on medical care
added to traditional psychiatric services will require increased finan
cial and personnel resources.