Skip to main content
Log in

Excess mortality by natural causes of italian schizophrenic patients

  • Original Articles
  • Published:
European archives of psychiatry and neurological sciences Aims and scope Submit manuscript

Summary

The risk of mortality over a 5- to 8-year period for a total 1-year prevalence cohort of schizophrenic patients extracted by means of the South-Verona Psychiatric Case Register (Italy) was assessed using three methods: (1) case control with both non-psychotic patients and the general population matched for sex and age; (2) indirect standardization using mortality tables; (3) a recently described method using survival tables. All methods yielded an excess mortality associated with schizophrenia, close to the two-fold increase described in other studies, while the survival tables method produced a higher standardized mortality ratio (SMR). The increased SMR did not appear solely attributable to suicide. Most deaths were attributable to natural causes. This is a departure from other recently reported mortality studies. The possible reasons are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Allebeck P, Wistedt B (1987) Mortality in schizophrenia. A tenyear follow-up based on the Stockholm County Inpatient Register. Arch Gen Psychiatry 43:650–653

    Google Scholar 

  • Armitage P (1971) Statistical methods in medical research. Blackwell, London

    Google Scholar 

  • Babigian HM, Odoroff CL (1969) The mortality experience of a population with psychiatric illness. Am J Psychiatry 126:470–480

    Google Scholar 

  • Balestrieri M, Micciolo R, Tansella M (1987) Long-stay and longterm psychiatric patients in an area with a community-based system of care. A register follow-up study. Int J Soc Psychiatry 33:251–262

    Google Scholar 

  • Black DW, Warrack G, Winokur G (1985) The Iowa record-linkage study. I–III. Arch Gen Psychiatry 42:71–88

    Google Scholar 

  • Bollini P, Muscettola G, Piazza A, Puca M, Tognoni G (1986) Mental health care in Southern Italy: application of case-control methodology for the evaluation of the impact of the 1978 psychiatric reform. Psychol Med 16:701–707

    Google Scholar 

  • Burti L, Garzotto N, Siciliani O, Siciliani O, Zimmermann-Tansella Ch, Tansella M (1986) South-Verona's psychiatric service: an integrated system of community care. Hosp Community Psychiatry 37:809–813

    Google Scholar 

  • De Girolamo B, Tumminello B (1986) Psichiatria italiana e riforma nella letteratura internazionale. Fogli Inform 120:1–36

    Google Scholar 

  • Giannichedda MG (1986) Preliminary report of Trieste for the WHO Regional Bureau for Europe's pilot study in mental health areas. Trieste

  • Harland A (1983) An efficient procedure for computerising exact confidence limits for a SMR. Comput Biomed Res 16:40–43

    Google Scholar 

  • Jablensky A, Henderson J (1983) Report on a visit to the South-Verona Community Psychiatric Service. World Health Organization Assignment Report. WHO, Geneva

    Google Scholar 

  • Jones K, Poletti A (1986) The Italian experience in mental health care. Hosp Community Psychiatry 37:795–801

    Google Scholar 

  • Lesage AD (1989) Sociological factors affecting clinical caseload in Italian good practice areas. Int J Soc Psychiatry 35:54–61

    Google Scholar 

  • Lesage AD, Mignolli G, Faccincani C, Tansella M (1990) Standardized assessment of the needs for care in a cohort of patients with schizophrenic psychoses. Psychol Med (in press)

  • Martin RL, Cloninger CR, Guze SB, Clayton PJ (1985) Mortality in a follow-up of 500 psychiatric outpatients. I–II. Arch Gen Psychiatry 42:47–66

    Google Scholar 

  • Mechanic D (1974) Politics, medicine and social sciences. Wiley, London

    Google Scholar 

  • Mignolli G, Faccincani C, Platt S (1990) Psychopathology and social performance in a cohort of patients with schizophrenic psychoses. A 7-year follow-up. Psychol Med (in press)

  • Mollica RF (1985) The unfinished revolution in Italian psychiatry. An international perspective. Int J Ment Health 14:1–2

    Google Scholar 

  • Mosher LR (1982) Italy's revolutionary mental health: an assessment. Am J Psychiatry 139:199–203

    Google Scholar 

  • Muscettola G, Casielle M, Bollini P, Sebastiani G, Pampallona S, Tognoni G (1987) Pattern of therapeutic intervention and role of psychiatric setting: a survey in two regions of Italy. Acta Psychiatr Scand 75:55–61

    Google Scholar 

  • Smythies JR (1985) On the current state of psychiatry in Northern Italy. Bull R Coll Psychiatr 14:149–154

    Google Scholar 

  • Sturt E (1983) Mortality in a cohort of long-term users of community psychiatric services. Psychol Med 13:441–446

    Google Scholar 

  • Tansella M, De Salvia D (1986) Case registers in comprehensive community psychiatric service areas in Italy. In: Horn GHMM ten, Giel R, Gulbinat WH, Henderson GH (eds) Psychiatric case registers in public health. Elsevier, Amsterdam, pp 140–145

    Google Scholar 

  • Tansella M, Faccincani C, Fiorio R, Mignolli G (1984) Epidemiologia e aspetti di terapia delle psicosi schizofreniche a Verona Sud. In: Faccincani C, Fiorio R, Mignolli G, Tansella M (eds) Le psicosi schizofreniche, dalla ricerca alla pratica clinica. Pàtron, Bologna, pp 65–106

    Google Scholar 

  • Tansella M, Faccincani C, Mignolli G, Balestrieri M, Zimmermann-Tansella Ch (1985) Il registro psichiatrico di Verona-Sud. Epidemiologia per la valutazione dei nuovi servizi territoriali. In: Tansella M (ed) L'approccio epidemiologico in psichiatria. Boringhieri, Turin, pp 225–259

    Google Scholar 

  • Tansella M, De Salvia D, Williams P (1987) The Italian psychiatric reform: some quantitative evidence. Soc Psychiatry 22:37–48

    Google Scholar 

  • Torre E (1985) Planning and evaluation of mental health services in Italy. In: Pichot P, Berner P, Wolf R, Thau K (eds) Psychiatry. Plenum Press, London, pp 71–77

    Google Scholar 

  • Tsuang MT, Simpson JC (1985) Mortality studies in psychiatry: should they stop or proceed? Arch Gen Psychiatry 42:98–103

    Google Scholar 

  • Tsuang MT, Woolson RF, Fleming JA (1980) Premature deaths in schizophrenia and affective disorders. Arch Gen Psychiatry 37:979–983

    Google Scholar 

  • Williams P, De Salvia D, Tansella M (1987a) Suicide, psychiatric reform and the provision of psychiatric services in Italy. Soc Psychiatry 21:89–95

    Google Scholar 

  • Williams P, De Salvia D, Tansella M (1987b) Suicide and the Italian psychiatric reform: an appraisal of two data collection systems. Eur Arch Psychiatr Neurol Sci 236:237–240

    Google Scholar 

  • Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, Cambridge

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lesage, A.D., Trapani, V. & Tansella, M. Excess mortality by natural causes of italian schizophrenic patients. Eur Arch Psychiatr Neurol Sci 239, 361–365 (1990). https://doi.org/10.1007/BF01734542

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01734542

Key words

Navigation