Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register.
<h4>Background</h4>People with personality disorder have reduced life expectancy, yet, within this population, little is known about the clinical predictors of natural and unnatural deaths. We set out to investigate this, using a large cohort of secondary mental health patients with pers...
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Public Library of Science (PLoS)
2014-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0100979 |
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| author | Marcella Lei-Yee Fok Robert Stewart Richard D Hayes Paul Moran |
| author_facet | Marcella Lei-Yee Fok Robert Stewart Richard D Hayes Paul Moran |
| author_sort | Marcella Lei-Yee Fok |
| collection | DOAJ |
| description | <h4>Background</h4>People with personality disorder have reduced life expectancy, yet, within this population, little is known about the clinical predictors of natural and unnatural deaths. We set out to investigate this, using a large cohort of secondary mental health patients with personality disorder.<h4>Methods</h4>We identified patients with an ICD-10 diagnosis of personality disorder, aged ≥15 years in a large secondary mental healthcare case register. The case register was linked to national mortality tracing. Using Cox regression, we modelled the effect of a number of pre-specified clinical variables on all-cause, natural cause and unnatural cause mortality.<h4>Findings</h4>2,440 patients were identified. Eighty-five deaths (3.5% of cohort) occurred over a 5-year observation period, of which over 50% were from natural causes. All-cause mortality was associated with alcohol or drug use (adjusted Hazard Ratio [aHR] 2.3; 95% CI 1.3-4.1), physical illness (aHR 1.9; 95% CI 1.0-3.6), and functional impairment (aHR 1.9; 95% CI 1.0-3.6). Natural cause mortality was associated with mild problems of alcohol or drug use (aHR 3.4; 95% CI 1.5-7.4), and physical illness (aHR 2.4; 95% CI 1.0-5.6). Unnatural cause mortality was associated only with severe alcohol or drug use (aHR 3.1; 95% CI 1.3-7.3).<h4>Interpretation</h4>Alcohol and drug use, physical illness, and functional impairment are predictors of mortality in individuals with personality disorder. Clinicians should be aware of the existence of problems in these domains, even at mild levels, when assessing the needs of patients with personality disorder. |
| format | Article |
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| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-39bf2d6dc08d49aba046a4a9e7ccfa8b2025-08-20T02:22:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e10097910.1371/journal.pone.0100979Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register.Marcella Lei-Yee FokRobert StewartRichard D HayesPaul Moran<h4>Background</h4>People with personality disorder have reduced life expectancy, yet, within this population, little is known about the clinical predictors of natural and unnatural deaths. We set out to investigate this, using a large cohort of secondary mental health patients with personality disorder.<h4>Methods</h4>We identified patients with an ICD-10 diagnosis of personality disorder, aged ≥15 years in a large secondary mental healthcare case register. The case register was linked to national mortality tracing. Using Cox regression, we modelled the effect of a number of pre-specified clinical variables on all-cause, natural cause and unnatural cause mortality.<h4>Findings</h4>2,440 patients were identified. Eighty-five deaths (3.5% of cohort) occurred over a 5-year observation period, of which over 50% were from natural causes. All-cause mortality was associated with alcohol or drug use (adjusted Hazard Ratio [aHR] 2.3; 95% CI 1.3-4.1), physical illness (aHR 1.9; 95% CI 1.0-3.6), and functional impairment (aHR 1.9; 95% CI 1.0-3.6). Natural cause mortality was associated with mild problems of alcohol or drug use (aHR 3.4; 95% CI 1.5-7.4), and physical illness (aHR 2.4; 95% CI 1.0-5.6). Unnatural cause mortality was associated only with severe alcohol or drug use (aHR 3.1; 95% CI 1.3-7.3).<h4>Interpretation</h4>Alcohol and drug use, physical illness, and functional impairment are predictors of mortality in individuals with personality disorder. Clinicians should be aware of the existence of problems in these domains, even at mild levels, when assessing the needs of patients with personality disorder.https://doi.org/10.1371/journal.pone.0100979 |
| spellingShingle | Marcella Lei-Yee Fok Robert Stewart Richard D Hayes Paul Moran Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register. PLoS ONE |
| title | Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register. |
| title_full | Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register. |
| title_fullStr | Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register. |
| title_full_unstemmed | Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register. |
| title_short | Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register. |
| title_sort | predictors of natural and unnatural mortality among patients with personality disorder evidence from a large uk case register |
| url | https://doi.org/10.1371/journal.pone.0100979 |
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