July 1991

Excess Mortality Among 3302 Patients With 'Pure' Anxiety Neurosis

Author Affiliations

From the Department of Psychiatry at Huddinge (Sweden) University Hospital, the Karolinska Institute, Stockholm, Sweden (Dr Allgulander); the Department of Psychiatry, Washington University, St Louis, Mo (Dr Allgulander when visiting lecturer); and the Department of Psychiatry and Human Behavior, Brown University, Providence, RI (Dr Lavori).

Arch Gen Psychiatry. 1991;48(7):599-602. doi:10.1001/archpsyc.1991.01810310017004

• The survival probability and causes of death before the age of 70 years were analyzed among 3302 inpatients with "pure" anxiety neurosis in Stockholm County, Sweden, who were tracked in case registries by means of automated record linkage during a 14-year period. When all patients with other psychiatric diagnoses and substance abuse were excluded, and marital status controlled for, there was a significant excess of deaths due to verified and undetermined suicides, ie, nearly one third of all deaths. These unnatural deaths preempted any excess in natural causes before the age of 70 years, such as cardiovascular disease. Treatment policy with regard to the use of anxiolytic drugs was not found to influence mortality. We concluded that the risk of suicide in inpatients before the age of 70 years with anxiety disorders may be as high as that in persons with depression or other diagnoses who require inpatient care.