substance abuse and psychiatric co-morbidity as predictors of premature mortality in swedish drug abusers a prospective longitudinal study 1970 - 2006药物滥用和精神伴随疾病的预测过早死亡率的瑞典药物滥用前瞻性纵向研究1970 - 2006.pdf

Nyhlén et al. BMC Psychiatry 2011, 11:122 /1471-244X/11/122 RESEARCH ARTICLE Open Access Substance abuse and psychiatric co-morbidity as predictors of premature mortality in Swedish drug abusers a prospective longitudinal study 1970 - 2006 1 2* 3 4 5 Anna Nyhlén , Mats Fridell , Martin Bäckström , Morten Hesse and Peter Krantz Abstract Background: Few longitudinal cohort studies have focused on the impact of substances abused and psychiatric disorders on premature mortality. The aim of the present study was to identify predictors of increased risk of drug related death and non drug related death in substance abusers of opiates, stimulants, cannabis, sedatives/ hypnotics, hallucinogens and alcohol over several decades. Methods: Follow-up study of a consecutive cohort of 561 substance abusers, admitted to a detoxification unit January 1970 to February 1978 in southern Sweden, and followed up in 2006. Demographic and clinical data, substance diagnoses and three groups of psychiatric diagnoses were identified at first admission. Causes of death were coded according to ICD-10 and classified as drug related deaths or non drug related deaths. To identify the incidence of some probable risk factors of drug related premature death, the data were subjected to a competing risks Cox regression analysis. Results: Of 561 patients in the cohort, 11 individuals had either emigrated or could not be located, and 204/561 patients (36.4%) were deceased by 2006. The cumulative risk of drug related death increased more in the first 15 years and leveled out later on when non drug related causes of death had a similar incidence. In the final model, male gender, regular use of opiates or barbiturates at first admission, and neuro