Mental disorders and cause-specific mortality

BACKGROUND: The impact of clinically diagnosed mental disorders on mortality in the general population has not been established. Aims To examine mental disorders for their prediction of cause-specific mortality. METHOD: Mental disorders were determined using the 36-item version of the General Health Questionnaire and the Present State Examination in a nationally representative sample of 8000 adult Finns. RESULTS: During the 17-year follow-up period 1597 deaths occurred. The presence of a mental disorder detected at baseline was associated with an elevated mortality rate. The relative risk in men was 1.6(95% confidence interval 1.3-1.8) and in women, 1.4 (95% Cl 1.2-1.6). In men and women with schizophrenia the relative risks of death during the follow-up period were 3.3 (95% Cl 2.3-4.9) and 2.3 (95% Cl 1.3-3.8) respectively, compared with the rest of the sample. In both men and women with schizophrenia the risk of dying of respiratory disease was increased, but the risk of dying of cardiovascular disease was increased only in men with neurotic depression. CONCLUSIONS: Schizophrenia and depression are associated with an elevated risk of natural and unnatural deaths.