Magazine article Clinical Psychiatry News

Poor Medical Care May Explain Increased Mortality

Magazine article Clinical Psychiatry News

Poor Medical Care May Explain Increased Mortality

Article excerpt

NEW ORLEANS -- The association between mental illness--particularly mood disorder and schizophrenia--and excess mortality from cardiovascular disease is well known, but the cause has never been established, Dr. Benjamin G. Druss said at the annual meeting of the American Psychiatric Association.

It may be that suboptimal medical care plays at least a contributory role, he said. Given this risk, mental health professionals should take a more active role, not only in monitoring the health care their patients receive, but also in ensuring its adequacy.

Dr. Druss of Yale University, New Haven, reported on data from more than 88,000 Medicare patients who were followed as part of the Cooperative Cardiovascular Project. All had been hospitalized for acute myocardial infarction in 1994-1995. Psychiatric diagnoses were established by admission code, and the existence of five indicators of post-MI-care quality were identified by chart review: reperfusion therapy, aspirin, [beta]-blockers, ACE inhibitors, and smoking cessation counseling.

For each intervention, patients were categorized as "ideal" (clear candidates for the intervention), "eligible" (a gray zone where the intervention was possibly indicated), or "ineligible" (there was an absolute contraindication to the intervention).

The mentally ill and other patients were similar in age (mean 76 years) and cardiac disease severity, although the patients with psychiatric disorders were slightly less severely ill. After adjusting for demographic and other risk factors, mental illness was associated with a 19% increase in mortality in the year after MI, Dr. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.