CoChat
Sign Up
Cited by 271Cardiac Health and Mental HealthMental Health Treatment and AccessSchizophrenia research and treatment

Somatic hospital contacts, invasive cardiac procedures, and mortality from heart disease in patients with severe mental disorder

Laursen, Thomas Munk, Munk-Olsen, Trine, Agerbo, Esben, Gasse, Christiane, Mortensen, Preben Bo·2009·Archives of General Psychiatry
DOI 10.1001/archgenpsychiatry.2009.61
Open this paper in CoChat — free account

Abstract

CONTEXT: Excess mortality from heart disease is observed in patients with severe mental disorder. This excess mortality may be rooted in adverse effects of pharmacological or psychotropic treatment, lifestyle factors, or inadequate somatic care. OBJECTIVES: To examine whether persons with severe mental disorder, defined as persons admitted to a psychiatric hospital with bipolar affective disorder, schizoaffective disorder, or schizophrenia, are in contact with hospitals and undergoing invasive procedures for heart disease to the same degree as the nonpsychiatric general population, and to determine whether they have higher mortality rates of heart disease. DESIGN, SETTING, AND PARTICIPANTS: A population-based cohort of 4.6 million persons born in Denmark was followed up from 1994 to 2007. Rates of mortality, somatic contacts, and invasive procedures were estimated by survival analysis. MAIN OUTCOME MEASURES: Incidence rate ratios of heart disease admissions and heart disease mortality as well as probability of invasive cardiac procedures. RESULTS: The incidence rate ratio of heart disease contacts in persons with severe mental disorder compared with the rate for the nonpsychiatric general population was only slightly increased, at 1.11 (95% confidence interval, 1.08-1.14). In contrast, their excess mortality rate ratio from heart disease was 2.90 (95% confidence interval, 2.71-3.10). Five years after the first contact for somatic heart disease, the risk of dying of heart disease was 8.26% for persons with severe mental disorder (aged <70 years) but only 2.86% in patients with heart disease who had never been admitted to a psychiatric hospital. The fraction undergoing invasive procedures within 5 years was reduced among patients with severe mental disorder as compared with the nonpsychiatric general population (7.04% vs 12.27%, respectively). CONCLUSIONS: Individuals with severe mental disorder had only negligible excess rates of contact for heart disease. Given their excess mortality from heart disease and lower rates of invasive procedures after first contact, it would seem that the treatment for heart disease offered to these individuals in Denmark is neither sufficiently efficient nor sufficiently intensive. This undertreatment may explain part of their excess mortality.

Integrity signals

Registry

Crossref · 10.1001/archgenpsychiatry.2009.61

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A Danish study found rates of invasive procedures were considerably lower and survival after first contact to hospital for heart disease was reduced in persons with schizophrenia compared to the general population.

    “A Danish study has found that the rates of invasive procedures were considerably lower and the survival after first contact to a hospital for heart disease was reduced in persons with schizophrenia compared to the general population (Laursen et al. 2009).”

    From Excess early mortality in schizophrenia. (2014) · cites this paper as Laursen et al. 2009

  • Underdiagnosis of somatic disorders in schizophrenic patients has been described in many studies.

    “Underdiagnosis of somatic disorders in schizophrenic patients has been described in many other studies (Frayne et al. 2005, Laursen et al. 2009, Osborn et al. 2008).”

    From Excess early mortality in schizophrenia. (2014) · cites this paper as Laursen et al. 2009

  • Patients with psychiatric disorders receive less treatment for physical conditions than do people without psychiatric disorders.

    “This interpretation is supported by studies documenting that patients with psychiatric disorders receive less treatment for physical conditions than do people without psychiatric disorders (Kisely et al. 2009, Laursen et al. 2009, Lawrence et al. 2000).”

    From Excess early mortality in schizophrenia. (2014) · cites this paper as Laursen et al. 2009

  • Patients with psychiatric disorders receive less treatment for physical conditions than people without psychiatric disorders.

    “This interpretation is supported by studies documenting that patients with psychiatric disorders receive less treatment for physical conditions than people without psychiatric disorders.[44], [52]–[54]”

    From Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden (2013) · cites this paper as [44]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Laursen, T. M., Munk-Olsen, T., Agerbo, E., Gasse, C., & Mortensen, P. B.
Affiliations
Aarhus University (DK)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2009-07-01
Volume
66
Issue
7
Pages
713
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archgenpsychiatry.2009.61
OpenAlex
W2057463503
Cited by
271
References
40
Citations by year
2026: 5 · 2025: 5 · 2024: 6 · 2023: 4 · 2022: 8 · 2021: 16 · 2020: 18 · 2019: 17 · 2018: 11 · 2017: 12 · 2016: 28 · 2015: 24 · 2014: 20 · 2013: 25 · 2012: 20
FWCI
15.52
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
severe mental illness, heart disease mortality, invasive cardiac procedures, psychiatric hospitalization, schizophrenia, bipolar disorder, schizoaffective disorder, psychotropic drugs, cardiovascular risk
MeSH terms
Adult, Aged, Aged, 80 and over, Coronary Artery Bypass, Bipolar Disorder, Cause of Death, Coronary Disease, Cross-Sectional Studies, Denmark, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Patient Admission, Probability, Psychotic Disorders, Reference Values, Referral and Consultation, Schizophrenia, Utilization Review, Cohort Studies, Comorbidity, Angioplasty, Balloon, Coronary, Incidence, Survival Rate, Survival Analysis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review