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首页> 外文期刊>The International journal of social psychiatry >Mortality and psychiatric disorders among public mental health care clients in Utrecht: A register-based cohort study
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Mortality and psychiatric disorders among public mental health care clients in Utrecht: A register-based cohort study

机译：乌得勒支公共精神卫生保健服务对象的死亡率和精神疾病：基于登记的队列研究

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Background: Different studies have shown similar or even lower mortality among homeless persons with compared to homeless persons without a severe mental disorder. Aims: To clarify the association between presence of a psychiatric diagnosis and mortality among the socially marginalized. Methods: The Public Mental health care (PMHc) is a legal task of the municipal authority aiming at prevention and intervention in case of (imminent) homelessness among persons with a serious shortage of self-sufficiency. The data of PMHc clients (N=6,724) and personally matched controls (N=66,247) were linked to the registries of Statistics Netherlands and analysed in a Cox model. Results: The increased mortality among PMHc clients, compared to the general population (HR=2.99, 95%-CI: 2.63-3.41), was associated with a broad range of death causes. Clients with a record linkage to the Psychiatric Case Registry Middle Netherlands ('PMHc+') had an increased risk of suicide (HR=2.63, 0.99-7.02, P=0.052), but a lower risk of natural death causes (HR=0.71, 0.54-0.92, P=0.011), compared to clients without this record linkage ('PMHc-'). Compared to controls, however, 'PMHc-' clients experienced substantially increased risks of suicide (HR=3.63, 1.42-9.26, P=0.007) and death associated with mental and behavioural disorders (ICD-10 Ch.V) (HR=7.85, 3.54-17.43, P<0.001). Conclusion: Psychiatric services may deliver an important contribution to the prevention of premature natural death among the socially marginalized.Keyphrases The earlier observed lower mortality among vulnerably housed and homeless persons with a psychiatric diagnosis compared to vulnerably housed and homeless persons without a psychiatric diagnosis appears to be due to a significantly lower risk of natural causes of death. Compared to controls from the general population, vulnerably housed and homeless persons without registered diagnosis at a local psychiatric service have a significantly increased mortality associated both with natural death causes and with suicide and death due to mental and behavioural disorders. Services for mental health care may deliver an important contribution to the prevention of premature death due to somatic disorders among the socially marginalized.
机译：背景：不同的研究表明，与无严重精神障碍的无家可归者相比，无家可归者的死亡率相近甚至更低。目的：明确精神病诊断的存在与社会边缘化人群的死亡率之间的关系。方法：公共精神卫生保健（PMHc）是市政当局的一项法律任务，旨在预防和干预严重自给自足的人中（即将）无家可归的情况。 PMHc客户（N = 6724）和个人匹配的控件（N = 66247）的数据已链接到荷兰统计局，并在Cox模型中进行了分析。结果：与普通人群（HR = 2.99，95％-CI：2.63-3.41）相比，PMHc客户的死亡率增加与广泛的死亡原因有关。与荷兰中部精神病案件登记处（'PMHc +'）有记录联系的客户自杀风险增加（HR = 2.63，0.99-7.02，P = 0.052），但自然死亡原因的风险较低（HR = 0.71， 0.54-0.92，P = 0.011），而没有此记录链接的客户（“ PMHc-”）。但是，与对照组相比，“ PMHc-”患者的自杀风险（HR = 3.63，1.42-9.26，P = 0.007）和与精神和行为障碍相关的死亡（ICD-10 Ch.V）（HR = 7.85）大大增加。 ，3.54-17.43，P <0.001）。结论：精神病服务可能为预防社会边缘化人群的过早自然死亡做出重要贡献。是由于自然死亡原因的风险大大降低。与一般人群的对照相比，在当地精神病学机构未得到明确诊断的脆弱住房和无家可归者的死亡率与自然死亡原因以及因精神和行为障碍导致的自杀和死亡有关，死亡率显着增加。精神保健服务可为预防社会边缘人群中的躯体疾病导致的过早死亡做出重要贡献。

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