December 9, 2011Open Access

Mortality in people with depressive, anxiety and alcohol use disorders in Finland

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Depressive, anxiety and alcohol use disorders. Intervention: Depressive, anxiety and alcohol use disorders. Primary outcome: Mortality (HR 1.97 (depressive), HR 1.72 (alcohol use)).

NMNiina MarkkulaCity of Helsinki THTommi HärkänenFinnish Institute for Health and Welfare JPJonna PeräläNational Institutes of Health

Key Result

Depressive and alcohol use disorders were significantly associated with increased mortality (HR 1.97 and HR 1.72, respectively) over an 8-year follow-up.

Study Design

Type

Cohort

Structured PICO

Are depressive, anxiety, and alcohol use disorders associated with increased mortality in a nationally representative sample of adults?

Population

Nationally representative sample of Finns aged 30-70 years

Intervention

Depressive, anxiety, and alcohol use disorders diagnosed with the Composite International Diagnostic Interview

Comparator

Individuals without these disorders (adjusted for sociodemographic factors, health status and smoking)

Outcome

Mortality (vital status and cause of death)hard clinical

Depressive and alcohol use disorders are associated with an increased mortality risk comparable to many chronic somatic conditions, independent of sociodemographic and somatic health status.

Main Result

Effect estimate: HR 1.97 (depressive), HR 1.72 (alcohol use)

Abstract

BACKGROUND: Mental disorders are associated with increased mortality, but population-based surveys with reliable diagnostic procedures controlling for somatic health status are scarce. AIMS: To assess excess mortality associated with depressive, anxiety and alcohol use disorders and the principal causes of death. METHOD: In a nationally representative sample of Finns aged 30-70 years, psychiatric disorders were diagnosed with the Composite International Diagnostic Interview. After an 8-year follow-up period, vital status and cause of death of each participant was obtained from national registers. RESULTS: After adjusting for sociodemographic factors, health status and smoking, depressive (hazard ratio (HR) = 1.97) and alcohol use disorders (HR = 1.72) were statistically significantly associated with mortality. Risk of unnatural death was increased among individuals diagnosed with anxiety disorders or alcohol dependence. CONCLUSIONS: Individuals with depressive and alcohol use disorders have an increased mortality risk comparable with many chronic somatic conditions, that is only partly attributable to differences in sociodemographic, somatic health status and hazardous health behaviour.

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