All-cause and cause-specific mortality in patients with depression in Scotland
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. Objectives T...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-03-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823009963/type/journal_article |
| Summary: | 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.
Objectives
To describe all-cause and cause-specific mortality of people with a hospital admission record for depression in Scotland, relative to the general population.
Methods
We 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.
Results
During 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
Conclusions
People 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 Interest
None Declared |
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| ISSN: | 0924-9338 1778-3585 |