Psychological Medicine

Research Article

A record-linkage study of mortality and general hospital discharge in patients diagnosed as schizophrenic1

H. E. Herrmana1 c1, J. A. Baldwina13 and David Christiea1

a1 Unit of Clinical Epidemiology, University of Oxford, Department of Community Health, University of Melbourne, Australia


Six hundred people diagnosed as schizophrenic by the specialist psychiatric services in Oxfordshire, between 1971 and 1973, were identified from the Oxford Psychiatric Case Register (OPCR). The person records of deaths and hospital discharges held by the Oxford Record Linkage Study (ORLS) were used to examine the following items of information for members of this group: details of discharges from and surgical operations performed in Oxfordshire non-psychiatric hospitals in a 6-year period before and a 4-year period after the date of first inclusion in the OPCR, and details of deaths in a 4-year period after the date of first inclusion in the OPCR.

The numbers of deaths, discharges and operations so observed in the study group were compared in age, sex and major diagnostic groups with the expected numbers derived from rates prevailing in the Oxfordshire population over the same periods. Observed deaths were twice as numerous as expected in both sexes, and the numbers of general hospital discharges were also higher than expected. Ischaemic heart disease was the commonest cause of death in both sexes, but did not account for the excessive numbers of hospital discharges. Trauma and poisoning accounted for the excess both of deaths in younger members of the study group and of general hospital discharges overall. Social and environmental difficulties associated with the diagnosis schizophrenia are likely to have contributed more than any inherent biological disadvantage to this excess.


c1 Address for correspondence: Dr H. E. Herrman, Mental Health Division, Health Commission of Victoria, 555 Collins Street, Melbourne 3000, Australia.


1 This paper is based on a thesis submitted for the Degree of Doctor of Medicine.

3 Formerly Medical Director of the Unit of Clinical Epidemiology, University of Oxford.