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Excess Mortality Among Psychiatric Patients

Eric Masterson, MB; Brian O'Shea, MB, MRCP
JAMA. 1985;254(3):360. doi:10.1001/jama.1985.03360030050016.
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To the Editor.—  We would like to discuss some points raised by Black et al.1 The phenomenally high incidence of deaths from suicides and accidents—32% of all deaths and 67% of excess deaths—remains difficult to comprehend despite an awareness of the increased mortality from suicide in psychiatric populations and the strong association between physical and psychiatric disorder.2 In our own study,3 schizophrenics died at a younger age than members of the general population as a result of an excess of cases of pneumonia as well as an increased incidence of suicide (18.9% died of pneumonia; 6.6% committed suicide—9.7% of males and 3.3% of females). One wonders about the difference between American and Irish smoking patterns and the distribution of unnatural deaths among the different subclasses of psychiatric disorder in the study by Black et al.The authors attempt to discover common themes in mortality patterns. It seems


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