Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T06:24:06.670Z Has data issue: false hasContentIssue false
  • English
  • Français

Sudden death in psychiatric patients

Published online by Cambridge University Press:  03 January 2018

David Ruschena ,
Paul E. Mullen ,
Philip Burgess ,
Stephen Cordner ,
Justin Barry-Walsh ,
Olaf Drummer ,
Simon Palmer ,
Chris Browne  and
Cameron Wallace
David Ruschena*
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Paul E. Mullen
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Philip Burgess
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Stephen Cordner
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Justin Barry-Walsh
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Olaf Drummer
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Simon Palmer
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Chris Browne
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
Cameron Wallace
Affiliation:
Department of Psychological Medicine, Department of Forensic Medicine, and Department of Physiology, Monash University and Mental Health Research Institute of Victoria
*
Professor P. E. Mullen, Department of Psychological Medicine. PO Box 266, Rosanna, Victoria 3084, Australia
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The present study investigated histories of prior psychiatric treatment in cases of sudden death reported to the coroner.

Methods

A matching survey linked the register of deaths reported to the coroner with a comprehensive statewide psychiatric case register covering both inpatient and community-based services.

Results

Sudden death was five times higher in people with histories of psychiatric contact. Suicide accounted for part of this excess mortality but deaths from natural causes and accidents were also elevated. Schizophrenic and affective disorders had similar suicide rates. Comorbid substance misuse doubled the risk of sudden death in affective and schizophrenic disorders.

Conclusions

The rates of sudden death are sufficiently elevated to raise questions about current priorities in mental health care. There is a need both for greater attention to suicide risk, most notably among young people with schizophrenia, to the early detection of cardiovascular disorders and to the vigorous management of comorbid substance misuse.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 4 , April 1998 , pp. 331 - 336
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allebeck, P. (1989) Schizophrenia: a life shortening disease. Schizophrenia bulletin, 15, 81–89.CrossRefGoogle ScholarPubMed
Armitage, P. & Berry, G. (1987) Statistical Methods in Medical Research. Oxford: Blackwell Scientific Publications.Google Scholar
Berren, M. R. Hill, K. R. Merikle, E. et al (1994) Serious mental illness and mortality rates. Hospital and Community Psychiatry, 45, 604–605.Google Scholar
Burgess, P. M. Joyce, C. M. Pattison, P. E. et al (1992) Social indicators and the prediction of psychiatric in-patient service utilization. Social Psychiatry and Psychiatric Epidemiology, 27, 83–94.Google Scholar
Corten, P. Ribourdouille, M. & Dramaix, M. (1991) Premature death among outpatients at a community mental health center. Hospital and Community Psychiatry, 42, 1248–1251.Google Scholar
Eaton, W. W. Mortensen, P. B. Herman, H. et al (1992) Long term course of hospitalisation for schizophrenia. Schizophrenia Bulletin, 18, 217–228.Google Scholar
Farr, W. (1841) Report upon the mortality of lunatics. Journal of the Statistical Society, 4, 17–33.Google Scholar
Gausset, M. F. Casadebaig, F. Gulllaud-Bataille, J. M. et al (1992) Mortalité des malades mentaux. L'Encéphale, 18, 93–100.Google Scholar
Hansen, V. Arnesen, E. & Jacobsen, B. K. (1997) Total mortality in people admitted to a psychiatric hospital. British Journal of Psychiatry, 170, 186–190.Google Scholar
Harris, E. C. & Barraclough, B. M. (1997) Suicide as an outcome for mental disorders. A meta-analysis. British Journal of Psychiatry, 170, 205–228.CrossRefGoogle ScholarPubMed
Holding, T. A. & Barraclough, B. M. (1975) Psychiatric morbidity in a sample of a London coroner's open verdicts. British Journal of Psychiatry, 127, 133–143.Google Scholar
Hollister, L. E. & Kosek, J. C. (1965) Sudden death during treatment with phenothiazine derivatives. Journal of the American Medical Association, 192, 1035–1038.CrossRefGoogle ScholarPubMed
Krupinski, J. Alexander, L. & Carson, N. (1982) Patterns of Psychiatric Care in Victoria. Special Publication No. 12. Melbourne: Health Commission of Victoria.Google Scholar
Lereya, J. Segal, A. & Elizur, A. (1995) Sudden death, neuroleptics and psychotic agitation. Progress in Neuro-Psychopharmacohgy and Biological Psychiatry, 19, 229–241.Google Scholar
Mehtonen, O. P. Malkonen, A. K. & Vapaalato, H. (1991) A survey of sudden death associated with the use of antipsychotic or antidepressant drugs: 49 cases in Finland. Acta Psychiatrica Scandinavica, 84, 58–64.Google Scholar
Naik, P. C. Davies, S. Buckley, A. M. et al (1997) Long term mortality after first psychiatric admission. British Journal of Psychiatry, 170, 43–46.Google Scholar
Ødegard, O. (1952) The excess mortality of the insane. Acta Psychiatrica et Neurologica Scandinavica, 28, 353–367.Google Scholar
Rossler, H. W. Fätkenheuer, B. & Löftier, W. (1995) Mortality among patients in psychiatric hospitals in Germany. Acta Psychiatrica Scandinavica, 91, 174–179.Google Scholar
Sims, A. (1987) Why the excess mortality from psychiatric illness? British Medical Journal, 294, 986–987.Google Scholar
Vieweg, V. & Levenson, J. (1995) Medical disorders in the schizophrenic patient. International Journal of Psychiatry in Medicine, 25, 137–172.Google Scholar
Whyman, A. (1976) Phenothiazine death: an unusual case report. Journal of Nervous and Mental Disease, 163, 214–217.CrossRefGoogle ScholarPubMed
World Health Organization (1978) Mental Disorders: A Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Disease (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.