A long-term follow-up study of adolescent psychiatric in-patients. Part I.Predictors of early death

A total of 1095 adolescent psychiatric in-patients were followed up 15-33 y ears after hospitalization by record linkage to the National Registry of Ca uses of Death. On the basis of hospital records all patients were rediagnos ed according to DSM-IV and scored on data postulated to be predictors of ea rly death. The factors were investigated by Kaplan-Meyer survival analysis and Cox regression. Cox regression showed that male sex (relative risk (RR) = 2.7, 95% confidence interval (CI) = 1.9-3.9), psychoactive substance use disorder (RR = 2.9, CI = 2.0-4.0), short hospital stay (RR = 3.1, CI = 1.9 -5.5) and poor impulse control (RR = 1.6, CI = 1.1-2.2) remained strong and independent predictors of death. Patients with psychoactive substance use disorder had different predictors of death (male sex, short hospital stay, poor impulse control, poor parental relationship, and low socio-economic st atus) than did patients without this disorder (male sex, somatic disorder a t hospitalization, more than one hospitalization). In our patient populatio n it seemed possible to identify a subgroup of adolescent psychiatric in-pa tients with an extremely high mortality (about 40%), namely males with psyc hoactive substance use disorder and poor impulse control.