Mortality among patients with severe mental disorders from a rural community in South India

Abstract

Background: Even though excess mortality in patients with severe mental disorders (SMD) has been established in many high-income countries, literature on this from the low- and middle-income countries including India is rather scant. Our study seeks to estimate the standardized mortality ratio (SMR) of patients with SMD from a rural community in Tamil Nadu for the years 2011–2015. Materials and Methods: We included patients with SMD from four taluks of Pudukkottai district, Tamil Nadu, during the years 2011–2015. We collected information on a total number of patients with SMD registered, their sociodemographic details, alive/dead status, and cause of death from the clinic registers and patient case records. We used the crude death rates for rural Tamil Nadu for the years 2011–2015 for the calculation of SMR, which is calculated by the formula observed deaths/expected deaths. Results: The SMR of patients with SMD was 3.33, 2.76, 2.11, 1.91, and 1.89 in the years 2011–2015. Of the 74 total deaths in these 5 years, 62 (83.7%) were due to natural causes, while 12.2% died by suicide. Statistically significant differences were observed in age, education, and marital status between patients with SMD who were alive and dead. Conclusion: We observed nearly two-times higher mortality among patients with SMD in rural Tamil Nadu. Further research is needed to examine the reasons for increased mortality among patients with SMD and interventions to reduce this excess mortality.

Keywords

• bipolar disorder
• mortality
• schizophrenia
• severe mental disorders
• standardized mortality ratio
• suicide