Mortality rates increased among ATPD patients
MedWire News: Patients with acute and transient psychotic disorders (ATPD) have increased all-cause mortality rates compared with the general population, research shows.
This excess mortality among ATPD patients was particularly high for suicide, note Augusto Castagnini (University of Cambridge, UK) and Aksel Bertelsen (Aarhus Psychiatric University Hospital, Risskov, Denmark) in the journal Social Psychiatry and Psychiatric Epidemiology.
"ATPDs refer to a composite category of psychotic disorders featured by: (1) acute onset; (2) presence of polymorphic, schizophrenic or predominantly delusional syndromes; and (3) association or not with psychological stress," explain the researchers.
They say that although outcome and response to treatment are favorable and complete recovery usually occurs within 1-3 months, "ATPDs tend to recur and frequently change mainly either to schizophrenia or affective disorders."
However, unlike schizophrenia or affective disorders, little is known about mortality rates among ATPD patients.
To address this, the researchers studied data on all 503 patients, aged 15 years or older, who were listed in the Danish Psychiatric Central Register with a first-admission diagnosis of ATPD in 1996.
Using data from the Danish register of causes of death, the team compared mortality rates and causes of death among these patients for the period 1996-2001 with those in the general population.
In total, 70 ATPD patients died from natural causes and 17 died from unnatural causes over the study period, equating to a total mortality rate of 35.3 per 1000 person-years.
Compared with the general population, ATPD patients had a significantly higher mortality rate for all causes, at a standardized mortality ratio (SMR) of 2.9. Mortality rates for both natural and unnatural causes were higher in the ATPD patients than the general population, at SMRs of 2.5 and 9.2, respectively.
Among the ATPD patients, suicide was the cause of death associated with the highest SMR, at 30.9, the researchers note.
Castagnini and Bertelsen conclude: "ATPD is associated with excess mortality from both natural and unnatural causes, particularly from suicide in younger subjects."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Mark Cowen