3. Results
As stated, the mean yearly percent of PTD ≥5 days
among deaths of non-schizophrenic controls was around
0.5% (mean=0.5%, SD=0.5%, range 0–2.2%) during
the period studied (see Fig. 1). This means that approximately
1 of every 200 non-schizophrenic individuals lay
5 or more days before the body was discovered. By
contrast, the percent of deceased patients with schizophrenia
who had a PTD ≥5 days increased dramatically
over time (see Fig. 1). The first cases with a PTD≥5 days
appeared in 1970, and the percent of schizophrenic
patients with PTD ≥5 days increased consistently over
time to around 10% in 2005.
The number of psychiatric hospital beds used by
patients with schizophrenia decreased considerably
over the same time period (see Fig. 1). There was an
inverse relationship (Pearson's correlation coefficient
r=− 0.72) between the percent of schizophrenic patients
with PTD ≥5 days and the number of beds available to
these patients. A least-squares regression line for the
percentages of dead patients with schizophrenia having
a PTD ≥5 days each year for the time period 1970–
2005 is shown in the Fig. 1.
4. Discussion
This population-based investigation showed an
increase over time in the number and proportion of
patients with schizophrenia who were not discovered
until many days after death, which was correlated with
the decrease in the number of available hospital beds for
this group of patients.
Prior to 1970, when the “PTD-phenomenon” first
appeared among patients with schizophrenia, nearly
every such patient was admitted to the mental hospital.
We consider it likely that one explanation for the
increase after 1970 in the number of patients with
schizophrenia who were not discovered until late after
death may be the rapidly changing and often adverse
social environment of these patients, which has followed
the drastic reduction of specialized psychiatric
care, indicated by the decreasing number of available
beds. In particular, with regard to the complex social,
emotional and cognitive dysfunctions in these patients,
reducing available specialized psychiatric care may
exacerbate patients' psychiatric symptoms and social
isolation.
In conclusion, people suffering from schizophrenia in