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© 1995 Oxford University Press

research-article

Mortality in Psychiatric Patients, with a Specific Focus on Cancer Mortality Associated with Schizophrenia

MOTOHIRO SAKU*, SHINKAN TOKUDOME**, MASATO IKEDA{dagger}, SUMINORI KONO{ddagger}, KATSUYOSHI MAKIMOTO§, HIDEYUKI UCHIMURA||, AKIRA MUKAI and TAKESUMI YOSHIMURA*

*Department of Clinical Epidemiology, University of Occupational and Environmental Health Yahatanishi-Ku, Kitakyushu, 807, Japan.
**Department of Public Health, Medical School, Nagoya City University Nagoya, Japan.
{dagger}Department of Occupational Health Economics, University of Occupational and Environmental Health Kitakyushu, Japan.
{ddagger}Department of Public Health, National Defense Medical College Tokorozawa, Japan
§Sameshima Hospital Saga, Japan.
||Hizen Mental Hospital Saga, Japan
Fukuma Hospital Fukuoka, Japan.

Background. Higher mortality rates among psychiatric patients compared with the general population have been widelyreported. On the other hand, lower cancer mortality for schizophrenics has been occasionally pointed out. Few studies from Japan have investigated mortality among psychiatric patients, and this study is the first large-scale follow-up in this country.

Methods. A total of 4980 patients admitted to a national mental hospital from 1948 through 1982 were followed up until 31 August 1985. The standardIzed mortality ratios (SMR) were calculated in comparison to the general population, using the person-years method.

Results. The SMR for total deaths and those for malignancy were as follows for males/females respectively: 2.55/3.02 and 0.84/1.37 for schizophrenia, 1.76/2.37 and 1.44/2.10 for depression, 2.45/3.04 and 1.18/1.82 for mania, 1.81/1.90 and 0.27/1.07 for neurosis, 5.55/4 33 and 1.85/3.34 for alcohol/drug abuse, and 3.65/3.57 and 1.01/0.72 for organic brain syndrome.

Conclusions. The SMR for total deaths were significantly elevated in schizophrenia, depression, mania, neurosis, alcohol/drug abuse, and organic brain syndrome, respectively. The SMR for malignancy were not elevated not lowered significantly in any of these disease categories. The SMR for stomach cancer In male schizophrenics was significantly lower (0.27; P < 0.05)

Received 1 October 1994


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