Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980-1998.

BACKGROUND People with mental illness suffer excess mortality due to physical illnesses. AIMS To investigate the association between mental illness and ischaemic heart disease (IHD) hospital admissions, revascularisation procedures and deaths. METHOD A population-based record-linkage study of 210 129 users of mental health services in Western Australia during 1980-1998. IHD mortality rates, hospital admission rates and rates of revascularisation procedures were compared with those of the general population. RESULTS IHD (not suicide) was the major cause of excess mortality in psychiatric patients. In contrast to the rate in the general population, the IHS mortality rate in psychiatric patients did not diminish over time. There was little difference in hospital admission rates for IHD between psychiatric patients and the general community, but much lower rates of revascularisation procedures with psychiatric patients, particularly in people with psychoses. CONCLUSIONS People with mental illness do not receive an equitable level of intervention for IHD. More attention to their general medical care is needed.

[1]  R Haghighat,et al.  A unitary theory of stigmatisation: Pursuit of self-interest and routes to destigmatisation , 2001, British Journal of Psychiatry.

[2]  L. Appleby,et al.  Sudden unexplained death in psychiatric in-patients , 2000, British Journal of Psychiatry.

[3]  B. Druss,et al.  Mental disorders and use of cardiovascular procedures after myocardial infarction. , 2000, JAMA.

[4]  M. Heo,et al.  Antipsychotic-induced weight gain: a comprehensive research synthesis. , 1999, The American journal of psychiatry.

[5]  A. J. Bass,et al.  Population‐based linkage of health records in Western Australia: development of a health services research linked database , 1999, Australian and New Zealand journal of public health.

[6]  J. Waddington,et al.  Mortality in schizophrenia , 1998, British Journal of Psychiatry.

[7]  R. McCreadie,et al.  Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study , 1998, BMJ.

[8]  B. Barraclough,et al.  Excess mortality of mental disorder , 1998, British Journal of Psychiatry.

[9]  A. Glassman Cardiovascular effects of antidepressant drugs: updated , 1998, The Journal of clinical psychiatry.

[10]  C. Tennant,et al.  Nutrition and Obesity in the Chronic Mentally ILL , 1998, The Australian and New Zealand journal of psychiatry.

[11]  A. Dobson,et al.  Declining rates of coronary heart disease in New Zealand and Australia, 1983-1993. , 1997, American journal of epidemiology.

[12]  J. McGrath,et al.  People Living with Psychotic Illness: An Australian Study 1997-98 , 1997 .

[13]  T. Kendrick,et al.  Cardiovascular and Respiratory Risk Factors and Symptoms among General Practice Patients with Long-Term Mental Illness , 1996, British Journal of Psychiatry.

[14]  Martinsen Ew Physical fitness, anxiety and depression. , 1990 .

[15]  E. Martinsen Physical fitness, anxiety and depression. , 1990, British journal of hospital medicine.

[16]  H. Kraemer,et al.  Medical evaluation of psychiatric patients. I. Results in a state mental health system. , 1989, Archives of general psychiatry.

[17]  T. Silverstone,et al.  Prevalence of Obesity in Patients Receiving Depot Antipsychotics , 1988, British Journal of Psychiatry.

[18]  A. Gopalaswamy,et al.  Too many chronic mentally disabled patients are too fat , 1985, Acta psychiatrica Scandinavica.

[19]  E. Koranyi Morbidity and rate of undiagnosed physical illnesses in a psychiatric clinic population. , 1979, Archives of general psychiatry.

[20]  C. Patterson Psychiatrists and physical examinations: a survey. , 1978, The American journal of psychiatry.

[21]  J. Romano,et al.  Is there a stethoscope in the house (and is it used)? , 1977, Archives of general psychiatry.