Cause-specific mortality in psychiatric patients after deinstitutionalisation

Background Since the late 1970s, the psychiatric service system in Norway h as been changed gradually according to the principles of deinstitutionalisa tion. Aims To document the mortality of psychiatric patients in a deinstitutional ised service system. Methods The case register of a psychiatric hospital covering the period 198 0-1992 was linked to the Central Register of Deaths. Age-adjusted death rat es and standardised mortality ratios (SMRs) were computed. Results Patients with organic psychiatric disorders had significantly highe r mortality regardless of cause of death. SMRs ranged from 0.9 for death by cancer in women to 36.3 for suicide in men. For unnatural death, SMRs were highest in the first year after discharge. Compared to the periods 1950-19 62 and 1963-1974, there has been an increase in SMRs for cardiovascular dea th and suicide in both genders. Conclusions Deinstitutionalisation seems to have had as its cost a relative rise both in cardiovascular death and unnatural deaths for both genders, b ut most pronounced in men. Declaration of interest The Department of Psychiatry, University of Tromso, partially funded this study.