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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
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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 

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