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Biomedical subjects

C Hassall

Publications and source records attributed to C Hassall.

At least 19 recordsLinked to original sources
PubMed1996

Causes of death associated with psychiatric illness.

BACKGROUND: A prospective cohort analysis of mortality, among entrants to a population-based psychiatric case register, was undertaken to identify specific causes of death responsible for the increased risk of mortality previously reported in this large group of unselected patients. METHODS: The analysis was based on a study population of 16,871 cases, aged 15-89 years, from Worcester and Kidderminster Health Districts, entering the case register between 1974 and 1984 and generating a total of 85,073 patient-years (PYR) of observation. The underlying cause of death was coded to the relevant revision of the International Classification of Diseases (ICD). Numbers of deaths observed in the study population were compared with the number of deaths expected on the basis of mortality rates for England and Wales. Comparisons were made for eight main causes of death, aggregated at Chapter level of the ICD, and 11 categories of psychiatric diagnoses. Two indices of mortality were used for evaluation: relative risk (RR) = observed deaths/expected deaths; and excess mortality rate (EMR) = (observed-expected deaths)/PYR. RESULTS: RRs were significantly raised for accidents, including suicides, as anticipated, and for various main causes of death. The increased risk of accidental death was found across the majority of the 11 psychiatric diagnostic groups although the EMRs were low at less than 5/1000 PYR. Deaths from respiratory disorders gave rise to the highest RRs after accidental deaths, and were responsible for substantial excess mortality among in-patients and patients with psychotic illnesses (especially dementia). The largest numbers of deaths of both sexes were due to diseases of the circulatory system, with a 40 per cent excess of observed over expected values in the whole series. The excess was due mainly to deaths of in-patients and of patients with psychotic diagnoses. No excess of deaths owing to neoplasms was found for either in-patients or out-patient groups. CONCLUSIONS: The findings that psychiatric illness is associated with an increased risk of death from "natural' causes and that the level of risk was related to the severity and to the diagnostic category of the illness have implications for patterns of care and use of resources.

Adolescent↗
PubMed1994

Secretion of atrial and brain natriuretic peptides from human cardiac atrial explants in culture: effect of dynorphin.

We have previously developed a method for maintaining human cardiac explants in culture under serum-free conditions, for the assessment of cardiac endocrine function and myocardial growth factors. In order to assess the local role of dynorphin in the human heart, we studied the effects of dynorphin on the secretion of atrial natriuretic peptide and brain natriuretic peptide by human cardiac atrial explants. Dynorphin did not affect the basal secretion of brain natriuretic peptide, but clearly enhanced the release of atrial natriuretic peptide from the human cardiac explants in culture. The atrial content of brain natriuretic peptide was not significantly reduced, whereas the atrial content of atrial natriuretic peptide in cultured explants was reduced two-fold in the presence of dynorphin. These findings indicate that dynorphin may have a direct stimulatory effect on the release of atrial natriuretic peptide, but not brain natriuretic peptide, from human cardiac atria.

Atrial Natriuretic Factor↗
PubMed1988

A preliminary study of excess mortality using a psychiatric case register.

Systematic screening of death certificates referable to residents of two health districts covered by a psychiatric case register allows the study of excess mortality in unselected psychiatric patients from a defined area of known population. Deaths among the case register patients exceeded those expected by 80%; the relative risk was maximal during the first year after registration and was significantly raised in both sexes and in patients of all age-groups. Patients may be selected by service use and by diagnostic group: the excess mortality of "inpatients" both in relative and absolute terms exceeded that of "outpatients". For dementia patients both the relative risk and more notably the absolute risk was high, and the excess mortality was significantly raised in both sexes and all age-groups. It was again greatest during the first year after registration. Deaths of patients with schizophrenia and paranoid psychosis exceeded those expected by 40 per cent and the excess was limited to the first year after registration and occurred predominantly among men.

Adolescent↗
PubMed1984

Changing demands made by senile dementia on the National Health Service.

In 1976 and 1981 two studies were undertaken to identify the numbers of elderly severely mentally infirm patients receiving care in a range of institutions in Worcestershire and to examine the appropriateness of the special units planned for them. The numbers of planned places matched the totals of patients in care but the nature of the provision was wrong. The new units were planned for able bodied but demented patients, with a relatively low staff/patient ratio. The number of these patients had fallen by one third, being replaced by patients who needed heavy physical nursing care. The new units would not therefore be able to fulfil their planned role of providing cheaper care than did the geriatric or psychiatric hospitals.

Aged↗
PubMed1977

Family-doctor support for patients on a psychiatric case register.

The family-doctor consultations of 76 patients on a psychiatric case register and 76 matched controls were examined. During a two-year period the psychiatric patients consulted just over twice as often as the controls (p < 0.001). Contact with the psychiatric services did not reduce the psychiatric patients' demand for general-practitioner time.

England↗
PubMed1972

Suicide in Birmingham.

The number of deaths from suicide in the City of Birmingham has fallen dramatically over the past eight years. Investigation shows that this seems to be wholly due to a reduction in deaths due to domestic coal-gas.

Accidents, Home↗
PubMed1970

Reported sleep on maintenance haemodialysis.

Subjective estimates of sleep in patients undergoing maintenance haemodialysis at home showed significant differences between dialysis nights and other nights; both patients and spouses lost sleep on dialysis nights. The sleep debt thus accumulated was not so well repaid in spouses as in patients. No pronounced differences were found between sleep on various forms of maintenance haemodialysis, and sleep did not show a consistent change over the three days between dialyses. The findings are interpreted as indicating the importance of functional rather than physical causes of insomnia in dialysis patients.

Family↗