A comparison of the mortality due to mental, behavioural and nervous disorders of France and Italy using the multiple cause-of-death approach

Aline Desesquelles, Institut National d'Études Démographiques (INED)
Antonio Salvatore, Università di Roma "La Sapienza"
Marilena Pappagallo, Instituto Nazionale di Statistica (ISTAT)
Luisa Frova, Instituto Nazionale di Statistica (ISTAT)
Monica Pace, Instituto Nazionale di Statistica (ISTAT)
Viviana Egidi, Università di Roma "La Sapienza"
France Meslé, Institut National d'Études Démographiques (INED)

Though the monitoring of the mortality trends still relies on the underlying cause of the death, the multiple cause-of-death approach is emerging as a promising tool in order to study the mortality profile of ageing populations. At old ages, death is indeed often the final stage of a long morbid process that involves several conditions. We use this approach to compare the mortality due to mental and behavioural disorders (ICD-10, chapter 5) and to diseases of the nervous system (ICD-10, chapter 6) of Italy and France. The conditions belonging to these two chapters have been regrouped into eight groups that enable to assess the specific contributions of the Alzheimer’s disease, of the other dementias as well as of the chronic alcohol abuse. Our analysis is conducted for the two sexes and for two age groups (under/over the age of 80) separately. Data are for year 2003. We first evaluate the underestimation of the role played by these conditions when the underlying cause only is taken into account. We then examine what are the other causes frequently mentioned on the death certificates that involve one of these conditions. In a previous study, we found that the two countries present noticeable differences for both chapters under consideration. In particular, a disease of the respiratory system is more frequently contributing to these deaths in France than in Italy. Below the age of 80, the diseases of the nervous system are frequently associated with the mental disorders in Italy, while a frequent association between this latter group and the diseases of the digestive system is observed in France. This new study that bases on data at a more detailed level of the ICD, will provide further information on these differences.