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Abstract
All follow-up studies of causes of death in affective disordered patients have found
they have markedly elevated suicide rates and a less reproducible increased mortality
from other causes. The reported rates by gender, disorder type and treatment are more
variable.
Hospitalised affective disordered patients (n=406) were followed prospectively for
22 years or more. Later, mortality was assessed for 99% of them at which time 76%
had died.
Standardised Mortality Rates (observed deaths/expected deaths) for patients were elevated
especially for suicide and circulatory disorders in both men and women. Women actually
had higher suicide rates but that did not take into account the twofold increase in
general population rates for men. Unipolar patients had significantly higher rates
of suicide than bipolar Is or IIs. In all groups long term medication treatment with
antidepressants alone or with a neuroleptic, or with lithium in combination with antidepressants
and/or neuroleptics significantly lowered suicide rates even though the treated were
more severely ill. Although at the age of onset the suicide rates were most elevated,
from ages 30 to 70 the rates were remarkably constant despite the different courses
of illness.
The patients were identified as inpatients and followed prospectively. The treatments
were uncontrolled and are not quantifiable but were documented during the follow-up.
Men and women hospitalised for affective disorders have elevated mortality rates from
suicide and circulatory disorders. Unipolars have higher suicide rates than bipolar
Is or IIs. Long term medication treatment lowers the suicide rates, despite the fact
that it was the more severely ill who were treated.