SUDDEN-DEATH IN PSYCHIATRIC-PATIENTS

Background The present study investigated histories of prior psychiatr ic treatment in cases of sudden death reported to the coroner Methods A matching survey linked the register of deaths reported to the corone r with a comprehensive statewide psychiatric case register covering bo th inpatient and community-based services. Results Sudden death was fi ve times higher in people with histories of psychiatric contact. Suici de 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. Co nclusions 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 yo ung people with schizophrenia, to the early detection of cardiovascula r disorders and to the vigorous management of comorbid substance misus e.