Mortality and psychiatric disorders among public mental health care clients in Utrecht: A register-based cohort study

Fabian Termorshuizen, Addi PL van Bergen, Ronald BJ Smit, Hugo M Smeets and Erik JC van Ameijden

International Journal of Social Psychiatry, 2014, vol. 60, issue 5, 426-435

Abstract: Background: Different studies have shown similar or even lower mortality among homeless persons with compared to homeless persons without a severe mental disorder. Aims: To clarify the association between presence of a psychiatric diagnosis and mortality among the socially marginalized. Methods: The Public Mental health care (PMHc) is a legal task of the municipal authority aiming at prevention and intervention in case of (imminent) homelessness among persons with a serious shortage of self-sufficiency. The data of PMHc clients (N=6,724) and personally matched controls (N=66,247) were linked to the registries of Statistics Netherlands and analysed in a Cox model. Results: The increased mortality among PMHc clients, compared to the general population (HR=2.99, 95%-CI: 2.63-3.41), was associated with a broad range of death causes. Clients with a record linkage to the Psychiatric Case Registry Middle Netherlands (‘PMHc+’) had an increased risk of suicide (HR=2.63, 0.99-7.02, P=0.052), but a lower risk of natural death causes (HR=0.71, 0.54-0.92, P=0.011), compared to clients without this record linkage (‘PMHc-’). Compared to controls, however, ‘PMHc-’ clients experienced substantially increased risks of suicide (HR=3.63, 1.42-9.26, P=0.007) and death associated with mental and behavioural disorders (ICD-10 Ch.V) (HR=7.85, 3.54-17.43, P

Keywords: Mortality; psychiatry; homelessness; psychiatric case registry (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:60:y:2014:i:5:p:426-435

DOI: 10.1177/0020764013491942

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