Recent rise in supposedly stress dependent causes of death in psychiatric hospitals in Norway indicating increased “stress” in hospitals?

The present study comprises all deaths in Norwegian psychiatric hospitals in 1950-74 with the diagnosis of non-organic (functional) psychosis: 5106 deaths. Mortality declined in both sexes as did excess mortality which is now 1.7 times the general population in the male, and 2.3 times in the female sex. However, a significant rise in unnatural deaths (suicides and accidents) took place in both sexes during 1963-74, as mortality increased 2-3 times in comparison with 1950-62. This rise in unnatural deaths is probably directly related to the introduction of drug therapy, which created an increased need for protection of the hospital population. A challenge which the accompanying changes in the hospital environment have failed to meet. Cardio-vascular mortality increased considerably during 1963-74 in both sexes. The rise is most likely the combined result of an adverse effect of drug therapy in individual patients (obesity, physical inactivity, increased smoking habits), the reduced stress-relieving effect of hospitalisation through shorter stays in hospital and the liberalization policy. We may not yet have experienced the total adverse effect on mortality of the increase in behavioural risk factors in psychiatric patients. It is suggested that future mortality studies include psychiatric out-patients.