Mortality in psychiatric hospitals in Norway 1950--74

Abstract

The present investigation comprises all deaths in Norwegian psychiatric hospitals 1950--74: 10,413 deaths. Mortality in men declined from 361 per 10,000 before 1950 to 252 per 10,000 in 1969--74 and in women from 324 per 10,000 to 215 per 10,000 during the same periods. In the organic and symptomatic psychoses (mainly senile and arteriosclerotic) mortality ranged from six to ten times that of the general population, whereas in the non-organic (functional) psychoses mortality was only twice as high as in the general population. This discrepancy in mortality between organic and non-organic psychoses, which is caused by the somatic disorders with high lethality underlying the organic psychoses, suggests that mortality should be calculated separately for organic and non-organic psychoses, which is sometimes neglected. An increasing number of hospital admissions with organic, mainly senile, psychoses is to be expected in the future, as well as an increasing proportion of non-organic patients with slight psychotic symptoms and a low and possibly decreasing mortality. between 1950 and 1974 radical changes took place in the psychiatric hospitals which could have influenced mortality. Age-adjusted death rates from cardio-vascular diseases were actually higher in 1963--68 than in 1950--62, possibly indicating that an adverse effect of drug therapy on physical activity and somatic fitness had outweighed the stress-relieving effect. A significant rise in unnatural deaths (suicides and accidents) has been observed particularly since 1963. As in previous investigations from Norway 1926--41, cancer as cause of death was equal to or below the general population in the non-organic psychoses and somewhat higher in the organic psychoses.