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.