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965 – Mortality And Psychiatric Disorders Among Public Mental Health Care Clients In Utrecht: a Register-based Cohort Study

Published online by Cambridge University Press:  15 April 2020

F. Termorshuizen ,
A.P. van Bergen ,
R.B. Smit ,
H.M. Smeets  and
E.J. van Ameijden
F. Termorshuizen
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
A.P. van Bergen
Affiliation:
Department of Health Promotion and Epidemiology, Utrecht, The Netherlands
R.B. Smit
Affiliation:
Department of Social Health Care, Municipal Health Service Utrecht, Utrecht, The Netherlands
H.M. Smeets
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
E.J. van Ameijden
Affiliation:
Department of Health Promotion and Epidemiology, Utrecht, The Netherlands

Abstract

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Introduction

The mortality among homeless people is linked to the presence of psychiatric disorders.

Objectives

We compared the risk of specific death causes among clients of the Public Mental Health care (PMHc) in Utrecht with that of the general population, and assessed whether treatment at a local psychiatric service is associated with this risk.

Aims

To clarify the association between the presence of a mental disorder and mortality among the socially marginalized.

Methods

Out of 8,741 clients in the PMHc register, the records of 6,724 could be linked to the registries of Statistics Netherlands (CBS). Controls (N=66,247) from the population register were personally matched to a PMHc client. A Cox regression analysis was used to estimate hazard ratios (HR) of death.

Results

An increased all-cause mortality among PMHc clients compared to controls was found (HR=2.99, 95%-CI: 2.63- 3.41), associated with a broad range of death causes.PMHc clients with record linkage to the Psychiatric Case Registry Middle Netherlands (’PMHc+’) had an increased risk of suicide (HR=2.63, 0.99-7.02), but a lower risk of death from natural causes (HR=0.71, 0.54-0.92), compared to PMHc clients without (‘PMHc-’). Compared to controls, however, ‘PMHc-’ clients experienced increased risks of suicide (HR=3.63, 1.42-9.26) and death due to mental & behavioural disorders (HR=7.85, 3.54- 17.43).

Conclusion

Among PMHc clients, a registered diagnosis at a local psychiatric service appears to be favourably associated with lower mortality due to natural death causes. The high risk of suicide among ‘PMHc-’ clients probably indicates a high prevalence of undiagnosed mental disorders among PMHc clients.

Type
Abstract
Information
European Psychiatry , Volume 28 , Issue S1: Abstracts of the 21th European Congress of Psychiatry , 2013 , 28-E396
Copyright
Copyright © European Psychiatric Association 2013
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