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Mortality of Patients with Mood Disorders
Follow-up studies of causes of death in affectively ill patients typically find markedly
elevated suicide rates compared to the general population, while the increase in mortality
due to other causes appears to be much less pronounced. When subdivided by gender, diagnosis
and treatment, mortality rates vary considerably across studies. To address these questions,
we have analyzed data of a prospective study where patients hospitalized with a diagnosis of
affective disorders (n=406) were followed prospectively over a period of at least 22 years.
Of these patients, 292 died during the observation period. The causes of death could be
assessed for almost all of them.
Mortality Rates
Standardised mortality rates (observed deaths/expected deaths) were found to be generally
elevated, in particular with respect to suicides and cardiovascular diseases in both men and
women. Women tended to have higher suicide rates, but this might be an artifact due to
stratification problems in the general population. Unipolar patients had significantly higher
rates of suicide than patients with a diagnosis of bipolar illness (BP-I and BP-II).
Impact of Long-Term Medication
Long-term medication with antidepressants, neuroleptics, or lithium in combination with
antidepressants and/or neuroleptics significantly lowered suicide rates even though the
respective patients were more severely ill. The suicide rates turned out to be almost
constant between the ages of 30 to 70 years, largely independent of the time course of illness.
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Manlio Bacosi (1921-1998): Mirror image — mirror-inverted person (oil on canvas, 80 x 100cm).
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