ABSTRACT
Age-, sex-, race-, and employment-adjusted standardized mortality ratios (SMRs) were calculated for sailors committing suicide between 1990 and 1996 and compared with adjusted SMRs for civilians. Cluster analyses were conducted on annual rates from 1983 through 1995 to examine differences between comparison groups across time and location. Results showed fewer than expected suicides for Caucasian and African American males and a somewhat higher than expected suicide rate among other ethnic group males and among Caucasian women. The suicide rate showed an increase during the study period, with some evidence toward a clustering effect in time and space.
Subject(s)
Military Personnel/statistics & numerical data , Suicide/statistics & numerical data , Adolescent , Adult , Female , Humans , Male , Middle Aged , Space-Time Clustering , United StatesABSTRACT
We surveyed a number of inbred mouse strains for susceptibility to meningococcemia. Mice of all strains became bacteremic after intraperitoneal injection of a serogroup C, serotype 2a human disease isolate, but the strains differed in levels of bacteremia, indicating influences of the host genome on susceptibility. There was no significant correlation between level of bacteremia and differences at major histocompatibility or immunoglobulin loci; the Salmonella susceptibility locus, Ity; the complement C5 locus, Hc; the antibody response locus, xid; or the transferrin locus, Trf. However, the Lps locus, which influences a range of host cellular responses to endotoxin and affects susceptibility to Salmonella typhimurium, did influence susceptibility to meningococcemia. There were significant differences in levels of bacteremia between C3H/HeJ (Lpsd) mice and each of the other strains (all Lpsn). We confirmed the association of the Lpsd genotype with susceptibility by using coisogenic strains from two widely separated mouse lineages: C3H and B10. Lpsd mice experienced a 1,000-fold proliferation of bacteria and were bacteremic for days before clearing the infection. In contrast, Lpsn mice cleared the bacteremia in less than 1 day. There was no difference in meningococcal growth in vitro in serum from C3H/HeJ and coisogenic C3H/HeN (Lpsn) mice, suggesting that the Lps-related difference in susceptibility may involve a cellular response.
Subject(s)
Meningitis, Meningococcal/genetics , Mice, Inbred Strains/genetics , Animals , Genes , Meningitis, Meningococcal/microbiology , Mice , Mice, Inbred Strains/microbiology , Sepsis/genetics , Time FactorsABSTRACT
Of 688 schizophrenics admitted to a psychiatric hospital over a 10-year period, 14 committed suicide. The numbers of suicides for both males and females significantly exceeded expected rates. Most of these deaths (71%) occurred within 2 years of discharge. Although more men than women committed suicide, women were found to be at relatively greater risk for suicide. Male suicides were significantly older than female suicides. Relevant literature is reviewed and implications for treatment and further research are discussed.
Subject(s)
Schizophrenia/complications , Suicide/epidemiology , Adult , Age Factors , Depressive Disorder/complications , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Female , Follow-Up Studies , Hospitalization , Humans , Iowa , Male , Risk , Schizophrenia/diagnosis , Schizophrenic Psychology , Sex Factors , Suicide/psychology , United StatesABSTRACT
Of 5,412 patients admitted to the University of Iowa Psychiatric Hospital between Jan 1, 1972, and Dec 31, 1981, three hundred thirty-one died during the follow-up period, significantly more than expected. The risk for premature death was greatest among women and the young, especially those between the ages of 30 and 39 years. Risk was associated with all psychiatric diagnoses and was significantly higher among patients of either sex with an organic mental disorder or schizophrenia; women with acute schizophrenia, depressive neuroses, alcoholism, drug abuse, and psycho-physiologic disorders and special symptoms; and men with neuroses. Suicide and accidental death were more frequent than expected and were responsible for two thirds of the excess deaths. During the total time of follow-up, women were at risk for natural deaths but men were not. Our most important finding was that 99% of the excess deaths occurred within two years of discharge. During this period there were undue numbers of both "natural" and "unnatural" deaths. The first two years after discharge are a time of great risk for psychiatric patients, particularly women.
Subject(s)
Medical Record Linkage , Medical Records , Mental Disorders/mortality , Accidents , Adult , Age Factors , Aged , Female , Hospitals, Psychiatric , Humans , Iowa , Male , Middle Aged , Patient Discharge , Risk , Sex Factors , Suicide/epidemiology , Time FactorsABSTRACT
Of 543 patients with organic mental disorders hospitalized at the University of Iowa Psychiatric Hospital, Iowa City, during a ten-year period, 87 died. This mortality was significant based on a control population. Patients of all ages were at risk for early death, especially those younger than 40 years. Risk was greatest during the first two years of follow-up; thereafter the observed death rate approached the expected rate. Patients were at special risk for death from "natural" causes, particularly cancer and heart disease among women, and influenza or pneumonia or "other" natural causes among men. During the first two years of follow-up, men were also at risk for death from accidents or suicide. Women with alcohol- and drug-related psychoses were at risk for death early in follow-up, but the diagnosis was not associated with risk from "unnatural death" in either sex.
Subject(s)
Neurocognitive Disorders/mortality , Accidents , Adult , Age Factors , Aged , Alcoholism/mortality , Female , Follow-Up Studies , Hospitalization , Humans , Iowa , Male , Middle Aged , Risk , Sex Factors , Substance-Related Disorders/mortality , SuicideABSTRACT
In a prospective investigation of 5,412 formerly hospitalized psychiatric patients, 68 committed suicide and 38 died from accidental causes. Both figures are significantly in excess of expectations based on a relevant control population. Those at significant risk included men and women of all ages, except those older than 69 years. Comparison of standardized mortality ratios suggests relatively greater risk for women and young persons. Risk for suicide was significant for patients of both sexes with acute schizophrenia, schizophrenia, affective disorders, and alcohol and other drug abuse, for men with neuroses, and for women with depressive neuroses. Risk for accidental death was greatest for those aged from 30 to 49 years and for those with personality disorders.
Subject(s)
Accidents , Mental Disorders/mortality , Suicide , Adult , Age Factors , Aged , Alcoholism/mortality , Female , Follow-Up Studies , Hospitalization , Humans , Iowa , Male , Middle Aged , Mood Disorders/mortality , Personality Disorders/mortality , Prospective Studies , Risk , Schizophrenia/mortality , Sex FactorsABSTRACT
Our investigation of the pattern of mortality among former inpatients in nine diagnostic groups was based on deaths found among 4,869 former inpatients of the University of Iowa Psychiatric Hospital, Iowa City, during a ten-year period. Comparisons were made with expected values based on a relevant Iowa control population. The first two years of follow-up was a period of great risk but not after. Excessive mortality from "unnatural" causes was found among patients of either sex with an affective disorder, schizophrenia, alcohol or other drug abuse, and personality disorders, among men with acute schizophrenia or neuroses, and among women with depressive neuroses. Women with acute schizophrenia or a psychophysiologic disorder or special symptom were at risk for a "natural" death. These findings confirm the risk of reduced life span that patients in all nine categories share.
