Mortality of Public Mental Health Patients: A Singapore Experience

1993 ◽  
Vol 27 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Lionel Chee-Chong Lim ◽  
Li-Ping Sim ◽  
Peak-Chiang Chiam
Keyword(s):  
Mental Health ◽  
General Population ◽  
Older Patients ◽  
Public Mental Health ◽  
Younger Patients ◽  
Standardised Mortality Ratio ◽  
Common Diagnosis ◽  
Mental Health Patients ◽  
Mortality Ratio ◽  
Age And Sex

This study reports the Standardised Mortality Ratio (SMR) by age and sex among public mental health patients in Singapore. The authors also examine the differences between those who were classified as “inpatient deaths” and those who were classified as “outpatient deaths”. Mortality was 5.1 times that of the general population and the SMR was most accentuated in the younger, female patients. Of the 217 deaths documented over two years, schizophrenia was the most common diagnosis. Inpatient deaths (N = 120) occurred in older patients with prior physical illness who died of natural causes. In contrast, outpatient deaths (N = 97) involved younger patients with no previous illness and the majority jumped to their deaths. Mortality studies are necessary in monitoring the efficacy of mental health provisions.

scholarly journals Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients

2017 ◽  
Vol 126 (4) ◽  
pp. 1201-1211 ◽  
Author(s):  
Benjamin Brokinkel ◽  
Markus Holling ◽  
Dorothee Cäcilia Spille ◽  
Katharina Heß ◽  
Cristina Sauerland ◽  
...  
Keyword(s):  
General Population ◽  
Elderly Patients ◽  
Older Patients ◽  
The Elderly ◽  
Spinal Tumors ◽  
Subtotal Resection ◽  
High Grade ◽  
Younger Patients ◽  
Age And Sex

OBJECTIVE The purpose of this study was to compare long-term prognosis after meningioma surgery in elderly and younger patients as well as to compare survival of elderly patients with surgically treated meningioma to survival rates for the general population. METHODS Five hundred meningioma patients (median follow-up 90 months) who underwent surgery between 1994 and 2009 were subdivided into “elderly” (age ≥ 65 years, n = 162) and “younger” (age < 65 years, n = 338) groups for uni- and multivariate analyses. Mortality was compared with rates for the age- and sex-matched general population. RESULTS The median age at diagnosis was 71 in the elderly group and 51 years in the younger group. Sex, intracranial tumor location, grade of resection, radiotherapy, and histopathological subtypes were similar in the 2 groups. High-grade (WHO Grades II and III) and spinal tumors were more common in older patients than in younger patients (15% vs 8%, p = 0.017, and 12% vs 4%, p = 0.001, respectively). The progression-free interval (PFI) was similar in the 2 groups, whereas mortality at 3 months after surgery was higher and median overall survival (OS) was shorter in older patients (7%, 191 months) than in younger patients (1%, median not reached; HR 4.9, 95% CI 2.75–8.74; p < 0.001). Otherwise, the median OS in elderly patients did not differ from the anticipated general life expectancy (HR 1.03, 95% CI 0.70–1.50; p = 0.886). Within the older patient group, PFI was lower in patients with high-grade meningiomas (HR 24.74, 95% CI 4.23–144.66; p < 0.001) and after subtotal resection (HR 10.57, 95% CI 2.23–50.05; p = 0.003). Although extent of resection was independent of perioperative mortality, the median OS was longer after gross-total resection than after subtotal resection (HR 2.7, 95% CI 1.09–6.69; p = 0.032). CONCLUSIONS Elderly patients with surgically treated meningioma do not suffer from impaired survival compared with the age-matched general population, and their PFI is similar to that of younger meningioma patients. These data help mitigate fears concerning surgical treatment of elderly patients in an aging society.

Suicide and the economic situation in Europe: are we experiencing the development of a ‘reverse stigma’?

2016 ◽  
Vol 209 (4) ◽  
pp. 273-274 ◽  
Author(s):  
Konstantinos N. Fountoulakis
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
General Population ◽  
Scientific Literature ◽  
Mental Healthcare ◽  
Vulnerable Groups ◽  
Socioeconomic Environment ◽  
Mental Health Patients ◽  
To Receive ◽  
Determining Factor

SummaryThe prevailing picture in both the scientific literature and mass media is that the increase in unemployment acts as a generic risk factor on the entire population and increases the rate of suicide, suggesting that the socioeconomic environment is the determining factor and measures to improve it are the most suitable in the struggle to reduce the number of suicides. As a result, ‘horizontal’ actions targeting the general population are proposed rather than ‘vertical’ actions that target specific vulnerable groups. This is not only a mistake but it also constitutes a kind of ‘reverse’ stigma which deprives mental health patients of their right to receive special and targeted benefits, interventions and care, and deprives mental healthcare of valuable resources.

Prevalence of reported suicidal behaviour in the general population and mental health-care staff

2000 ◽  
Vol 30 (5) ◽  
pp. 1189-1196 ◽  
Author(s):  
INGA-LILL RAMBERG ◽  
DANUTA WASSERMAN
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Population ◽  
Mental Health Care ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Care Staff ◽  
Health Care Staff ◽  
Suicidal Thoughts ◽  
Age And Sex

Background. Higher rates of suicidal behaviour have been reported among staff in mental health care than in the general population. However, no studies of these two groups have been carried out simultaneously, using the same methods. This study aims to investigate whether they differ in terms of age- and sex-standardized prevalence of suicidal behaviour.Methods. Identical questions about suicidal behaviour were addressed in the same year to a random sample of the general population and to mental health-care staff in Stockholm. Life weariness among the latter was also investigated.Results. Age- and sex-standardized past year prevalences of suicidal thoughts and suicide attempts were found to be similar among mental health-care staff and the general population. Lifetime prevalence of both suicidal thoughts and suicide attempts was significantly higher among mental health-care staff than among the general population. Psychologists/social workers have a higher probability of: lifetime thoughts of life is not worth living; death wishes; and, suicidal thoughts, than nurses/assistant nurses.Conclusions. Reports on lifetime prevalence of suicidal behaviour may be biased in populations that are not reminded of these problems in everyday life. Data on past year prevalence of suicidal behaviour show clearly the similarity between the general population and the mental health-care staff.

scholarly journals Preferences for group arts therapies: a cross-sectional survey of mental health patients and the general population

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e051173
Author(s):  
Emma Millard ◽  
Emma Medlicott ◽  
Jessica Cardona ◽  
Stefan Priebe ◽  
Catherine Carr
Keyword(s):  
Mental Health ◽  
Informed Consent ◽  
General Population ◽  
Music Therapy ◽  
Art Therapy ◽  
Multinomial Logistic Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Arts ◽  
Mental Health Patients

ObjectivesThe arts therapies include music therapy, dance movement therapy, art therapy and dramatherapy. Preferences for art forms may play an important role in engagement with treatment. This survey was an initial exploration of who is interested in group arts therapies, what they would choose and why.DesignAn online cross-sectional survey of demographics, interest in and preferences for the arts therapies was designed in collaboration with patients. The survey took 10 min to complete, including informed consent and 14 main questions. Summary statistics, multinomial logistic regression and thematic analysis were used to analyse the data.SettingThirteen National Health Service mental health trusts in the UK asked mental health patients and members of the general population to participate.ParticipantsA total of 1541 participants completed the survey; 685 mental health patients and 856 members of the general population. All participants were over 18 years old, had capacity to give informed consent and sufficient understanding of English. Mental health patients had to be using secondary mental health services.ResultsApproximately 60% of participants would be interested in taking part in group arts therapies. Music therapy was the most frequent choice among mental health patients (41%) and art therapy was the most frequent choice in the general population (43%). Past experience of arts therapies was the most important predictor of preference for that same modality. Expectations of enjoyment, helpfulness, feeling capable, impact on mood and social interaction were most often reported as reasons for preferring one form of arts therapy.ConclusionsLarge proportions of the participants expressed an interest in group arts therapies. This may justify the wide provision of arts therapies and the offer of more than one modality to interested patients. It also highlights key considerations for assessment of preferences in the arts therapies as part of shared decision-making.

scholarly journals LO62: Systolic blood pressure is a strong predictive marker for TIA and mild stroke in younger patients

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S49
Author(s):  
C. Sedgwick ◽  
M. Bibok ◽  
N.S. Croteau ◽  
M.L. Lesperance ◽  
R. Balshaw ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Systolic Blood Pressure ◽  
Regression Model ◽  
Older Patients ◽  
Significant Risk ◽  
Younger Patients ◽  
Increased Risk ◽  
Age And Sex

Introduction: Age and systolic blood pressure (SBP) are important predictors of Acute Cerebrovascular Syndrome (ACVS). Yet, the effect of SBP is confounded by age, making its independent contribution to ACVS risk difficult to quantify. Here we use logistic regression to explore the role of SBP in younger and older ED patients. Methods: Data comprised 1019 ED patients (ACVS 70%, 30% non-ACVS) enrolled during a 28-month period of an ongoing prospective, observational, multi-site stroke biomarker study (SpecTRA). We used logistic regression to examine the effects of age, sex, and the age:SBP interaction as predictive markers of the diagnosis of ACVS. Results: Participants (53% male) ranged in age from 18 to 97 years (Q1=58, median=70, Q3=80). SBP ranged from 84 to 248 mmHg (Q1=137, median=154, Q3=174). In our initial regression model, age, sex, SBP and the age:SBP interaction were all significant (p&lt;0.01). Using cubic regression splines for age, sbp and their interaction yields the same conclusion (p&lt;0.01). To better understand the role of SBP in younger vs. older patients, we stratified the sample at the median age (70 years of age). In the younger group (n=510), participants were 55% male, 60% ACVS, and had SBP ranging from 91 to 236 mmHg (Q1=133, median=148, Q3=165). In the older group (n=509), participants were 51% male, 82% ACVS and had SBP ranging from 84 to 248 mmHg (Q1=143, median=159, Q3=179), a shift of approximately 10 mmHg between the groups. The logistic regression model was then fit separately to each group without the age:SBP interaction term. In the younger group, we found SBP to be highly significant (p&lt;0.001), with an odds-ratio (OR) of 1.18 per 10 mmHg (95% CI: 1.10-1.29). In the older group, we found that SBP was not significant (p=0.91), with an OR of 1.00 per 10 mmHg (95% CI: 0.91-1.08). Age and sex were also significant risk factors in the younger group (each p&lt;0.01), though not in the older group (both p&gt;0.07). Conclusion: Our findings suggest that for ED patients suspected of ACVS, SBP is a clinically relevant predictor for younger patients, with higher SBP associated with an increased risk of ACVS, regardless of patient age and sex. SBP does not appear to be a strong predictor for patients over 70. ED physicians can leverage this finding by attributing greater importance to elevated SBP in younger patients than older patients when working toward a clinical suspicion of ACVS.

Management of Elderly Patients with Rapidly Progressive Glomerulonephritis

2018 ◽  
Vol 45 (1-3) ◽  
pp. 213-217
Author(s):  
Zdenka Hruskova ◽  
Vladimir Tesar
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Elderly Population ◽  
Retrospective Studies ◽  
Severe Disease ◽  
Immunosuppressive Treatment ◽  
Rapidly Progressive Glomerulonephritis ◽  
The Elderly ◽  
Younger Patients ◽  
Common Diagnosis

Background: Rapidly progressive glomerulonephritis (RPGN) is characterized by a rapid deterioration of renal function and by extracapillary proliferation in >50% of glomeruli. The most common type of RPGN is “pauci-immune” glomerulonephritis caused by anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). Summary: The incidence of AAV increases with age and pauci-immune glomerulonephritis is the most common diagnosis found in renal biopsies in the elderly population. Age was identified as an independent negative risk factor for both death and end-stage renal disease in AAV, and the mortality of older patients was uniformly higher than in younger patients in all retrospective studies. Early diagnosis may be difficult particularly in elderly patients with renal-limited disease but is important for the good outcome of the patients. Immunosuppressive treatment options include cyclophosphamide or rituximab combined with corticosteroids with or without plasma exchange in case of severe disease. Data from randomized trials are completely missing for patient aged >75 years. Based on retrospective studies, elderly patients seem to respond to immunosuppressive drugs just as younger patients are able to, but they are at a higher risk of adverse events. Key Messages: RPGN is relatively common in the elderly patients. Immunosuppressive treatment in older patients with AAV or RPGN may be useful but needs to be strictly individualized with all the risks taken into consideration. Further studies are needed to examine the role of novel therapeutic options in the elderly population with RPGN.

THE RELATIONSHIP OF PSORIASIS TO SUICIDE: LITERATURE REVIEW

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Margarita Slabadienė ◽  
Karolina Minikavičiūtė ◽  
Jolanta Sauserienė
Keyword(s):  
Mental Health ◽  
General Population ◽  
Literature Review ◽  
Adverse Effects ◽  
Skin Condition ◽  
Review Articles ◽  
Mental Health Patients ◽  
Chronic Skin ◽  
Relationship Of ◽  
The Relationship

Psoriasis is a chronic skin condition that affects almost 3% of world’s population and is associated with potential adverse effects on mental health. Patients with psoriasis have a higher risk of depression, anxiety and suicide than the general population. The aim is to review articles published in 2010–2019 based on relations of psoriasis and suicide and to provide recommendations for physicians most frequently confronted with psoriasis.

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