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August 1981

Morbidity and Mortality in the Commitment Process

Author Affiliations

From the Department of Psychiatry, School of Medicine, University of Oregon Health Sciences Center, Portland (Drs Shore and Arvidson); and the Johns Hopkins Community Psychiatry Program, Henry Phipps Psychiatric Clinic, Baltimore (Dr Breakey).

Arch Gen Psychiatry. 1981;38(8):930-934. doi:10.1001/archpsyc.1981.01780330088010

• This study reports a prospective evaluation of 189 patients who entered the commitment process in Oregon. Patients were assessed for commitment status, morbidity, and mortality at six and 19 months. Twenty-nine percent were formally committed. The committed group consisted largely of violence-prone, psychotic patients plus a small number of elderly, demented subjects with serious medical illness. A mortality of 10% included the elderly who died of medical causes and young adult patients who completed suicide. The findings justify psychiatry's concern for patient welfare in commitment systems, especially for the group that is released and not committed. The study is compared with six additional commitment studies, with emphasis on methodology and implications for futher research.