Nine deaths among 29 patients with severe mental illness identified with high mortality using SSEPP

Nord J Psychiatry. 2018 Nov;72(8):543-548. doi: 10.1080/08039488.2018.1489893. Epub 2018 Sep 27.

Abstract

Purpose: It is an established consensus that patients suffering from Severe Mental Illness (SMI) often have somatic comorbidities and a shortened life expectancy. In this study, we examine to what extent previously unknown comorbidities can be revealed if patients suffering from SMI are examined by a specialist in general medicine using the new clinical tool of Systematic Somatic Examinations of Psychiatric Patients (SSEPP).

Methods: SSEPP is a detailed, in-depth questioning and clinical evaluation performed by a specialist in General medicine. A total of 112 patients were recruited from asylums for patients suffering from chronic and severe psychiatric disorders in the Copenhagen area. Diagnosis within SMI led to 106 patients included. 6 patients had no SMI diagnosis and were excluded. Four years later, deaths in the cohort were registered.

Results: Ninety percent of examined patients were found to have previously unknown indications for medical treatment. Nine deaths occurred among the examined patients during follow-up. All deaths happened among the 29 patients identified with high expected risk of ischemic manifestation (31%, p < .0001).

Conclusions: In this study, SSEPP is shown to be capable of: Identifying previously unknown and/or undertreated somatic comorbidity in patients with SMI. Identifying the patients with the highest risk of ischemic manifestation with a score of 9 deaths/29 patients. This is statistically significant (p < .0001). This study suggests that patients with SMI in every psychiatric ward be systematically examined for somatic comorbidity by GPs especially trained with tools like SSEPP.

Keywords: SSEPP; Severe mental illness; chronic obstructive lung disease; ischemic heart disease; mortality.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Comorbidity
  • Female
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Myocardial Ischemia / epidemiology*
  • Physical Examination
  • Pulmonary Disease, Chronic Obstructive / epidemiology*