Suicide and Other Causes of Death in the Psychiatric Patients of a Mental Health Service over a 5-year Period

Aims: 1) To compare mortality rate and causes of death between psychiatric patients of a Mental Health Department (MHD) and local population of Modena.

2) To appraise the impact of selected demographic and clinical variables on suicide.

Study Design: Retrospective analysis.

Place and Duration of Study: MHD of Modena between March 2009 and September 2009.

Methodology: Our psychiatric sample was composed by all psychiatric patients followed by the MHD of Modena, who died from 1-1-2004 to 31-12-2008 (n=168). We compared the standardized mortality rate and causes of death of our sample to those of the local population (n=250,000), who died during the same period of time, according to data provided by the registry of the Clinical Epidemiology Service of Modena. From computerized registration system and medical records of MHD and death certificates, we collected: demographic data, psychiatric diagnosis, death causes, time elapsed from the first consultation in MHD to death, time elapsed from the last discharge from psychiatric ward or from the last consultation in MHD to death. Our sample of psychiatric patients was further divided into two groups: the first one was composed of those who committed suicide (n=25) and the second one those that died from other causes (n=143), and all variables of each group were statistically compared to highlight the demographic and clinical features of the two groups.

Results: Neoplastic and cardiovascular diseases were the two most frequent causes of death in both psychiatric and local populations and suicide represented the third leading cause of death in the psychiatric sample. Psychiatric patients who committed suicide were statistically significantly younger in comparison to others and killed themselves after 12 days (median) from the last psychiatric consultation or hospital discharge.

Conclusion: Our patients presented the same high vulnerability to organic disorders and their fatal consequences as local population with higher risk of suicide which remains a fatal outcome of psychiatric diseases.