Every death at a psychiatric hospital raises questions about its cause and the forensic responsibilities it engages.

• - To assess the rate of deaths posing forensic problems at a psychiatric hospital.

• - To determine the patients’ victimological profile.

• - To identify the causes and risk factors of these deaths.

We conducted a retrospective and descriptive study based on the forensic autopsies and the medical files of patients who died during their stay at AlRazi psychiatric hospital between January 2000 and December 2010.

During the study period, 115 deaths were recorded. We studied the deaths of 33 autopsied patients (28.69% of all deaths). Patients are predominantly male (60%), aged 43 on average, mostly smokers (66%), with a low socioeconomic level (61%) and a medical history (40%) primarily of hypertension and diabetes. 40% of our casualties are schizophrenic, mostly of the paranoid form (60%). Antipsychotics are the most prescribed drugs (87.5%). High doses are used (mean chlorpromazine equivalent dose: 1237 mg/day). Most deaths occurred at night, during weekends. 21% died within the first 24 hours of their hospital stay. A cause for death was identified in ¾ of cases. 75.75% are sudden deaths mainly due to respiratory (40%), or cardiovascular causes (20%). Accidental deaths (18.18% of all deaths) include choking (50%), thermal burns (33.4%) and iatrogenic causes (16.6%). Suicides account for 6% of all deaths.

Reducing the incidence of deaths posing forensic problems at psychiatric hospitals is an important goal to achieve through careful identification of risk factors.