The impact of psychiatric and medical comorbidity on the risk of mortality: a population-based analysis
| Autor: | Tomisin Iwajomo, Robert J. Reid, Claire de Oliveira, Paul Kurdyak, Simon J. C. Davies, Judith Versloot |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Comorbidity Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine medicine Risk of mortality Humans 030212 general & internal medicine education Psychiatry Applied Psychology Aged Aged 80 and over Ontario education.field_of_study Depressive Disorder Major business.industry Mental Disorders Hazard ratio Middle Aged medicine.disease 030227 psychiatry Psychiatry and Mental health Paranoid personality disorder Cohort Schizophrenia Major depressive disorder Female business Cohort study |
| Zdroj: | Psychological medicine. 51(2) |
| ISSN: | 1469-8978 0033-2917 |
| Popis: | BackgroundAs life expectancy increases, more people have chronic psychiatric and medical health disorders. Comorbidity may increase the risk of premature mortality, an important challenge for health service delivery.MethodsPopulation-based cohort study in Ontario, Canada of all 11 246 910 residents aged ⩾16 and ® (v10.0); ADG 25: Persistent/Recurrent unstable conditions; e.g. acute schizophrenic episode, major depressive disorder (recurrent episode), ADG 24: Persistent/Recurrent stable conditions; e.g. depressive disorder, paranoid personality disorder, ADG 23: Time-limited/minor conditions; e.g. adjustment reaction with brief depressive reaction. The outcome was all-cause mortality (April 2014–March 2016).ResultsOver 2 years' follow-up, there were 188 014 deaths (1.7%). ADG 25 conferred an almost threefold excess mortality after adjustment compared to having no psychiatric morbidity [adjusted hazard ratio 2.94 (95% CI 2.91–2.98, p < 0.0001)]. Adjusted hazard ratios for ADG 24 and ADG 23 were 1.12 (95% CI 1.11–1.14, p < 0.0001) and 1.31 (95% CI 1.26–1.36, p < 0.0001). In all 10 medical disorder cohorts, ADG 25 carried significantly greater mortality risk compared to no psychiatric comorbidity.ConclusionsPsychiatric disorders, particularly those graded persistent/recurrent and unstable, were associated with excess mortality in the whole population, and in the medical disorder cohorts examined. Future research should examine whether service design accounting for psychiatric disorder comorbidity improves outcomes across the spectrum of medical disorders. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|