1 results
All-cause and cause-specific mortality in patients with depression in Scotland
- R. Alotaibi, N. Halbesma, S. Wild, C. A. Jackson
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S464-S465
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Premature mortality in people with depression is well established. A better understanding of the causes of death and the relative risks of death from each cause may help identify factors that contribute to the health inequalities between people with and without depression.
ObjectivesTo describe all-cause and cause-specific mortality of people with a hospital admission record for depression in Scotland, relative to the general population.
MethodsWe used a linked population-based dataset of all psychiatric hospital admissions in Scotland to the national death dataset to identify 28,837 adults ≥18 years of age who had a hospital admission record of depression between 2000 and 2019. We obtained general population estimates and mortality data from the National Records of Scotland and quantified the relative difference in mortality by calculating the standardised mortality ratio (SMR), using indirect standardisation and stratifying by sex.
ResultsDuring a median follow-up of 8.1 years, 7,931(27.5%) people who were hospitalised for depression died. Circulatory system diseases were the most common causes of death. Standardised all-cause mortality was more than three times higher than would be expected based on death rates in the general Scottish population. SMRs were similar in men and women for all-cause mortality and, in general, for cause-specific death (Table 1). The SMR for the suicide category was markedly higher in women than men, partly explained by the higher suicide mortality in males than females in the general population.
Table 1 All-cause and cause-specific mortality of people hospitalised for depression in Scotland 2000-19 Observed deaths, n (All) Expected deaths, n (All) SMR (95% CI) (All) Observed deaths, n (Male) Expected deaths, n (Male) SMR (95% CI) (Male) Observed deaths, n (Female) Expected deaths, n (Female SMR (95% CI) (Female) All-cause 7,931 2427 3.3(3.2-3.3) 3617 1052 3.4(3.3-3.5) 4314 1375 3.1(3.0-3.2) Circulatory system diseases 2,020 806 2.5(2.4-2.6) 886 343 2.6(2.4-2.7) 1,134 463 2.4(2.3-2.6) Neoplasms 1,153 682 1.7(1.6-1.8) 534 306 1.7(1.6-1.9) 619 376 1.6(1.5-1.8) Respiratory system diseases 1,106 292 3.8(3.6-4.0) 453 112 4.0(3.7-4.4) 653 180 3.6(3.3-3.9) Mental & behavioural disorders 835 131 6.4(5.9-6.8) 333 52 6.4(5.7-7.2) 502 79 6.3(5.8-6.9) Accidents 395 69 5.7(5.2-6.3) 224 38 5.9(5.1-6.7) 171 31 5.5(4.7-6.3) Suicide, self-harm & injuries of undetermined Intent 805 53 15.2(14.1-16.2) 485 39 12.4(11.3-13.5) 320 14 22.9(20.3-25.4) Other external cause 28 6 4.7(2.9-6.4) 16 3 5.3 (2.7- 7.9) 12 3 4.0(1.7-6.3) Other natural diseases 1,589 388 4.1(3.9-4.3) 686 159 4.3 (4.0-4.6) 903 229 3.9(3.7-4.2) CI: Confidence interval; SMR: Standardised mortality ratio
ConclusionsPeople hospitalised for depression continue to have higher all-cause mortality than the general population in Scotland, with relative mortality varying by cause of death.
Disclosure of InterestNone Declared