精神障碍与意外死亡风险。

Mental disorders and risk of accidental death.

机构信息

Casey Crump, MD, PhD, Department of Medicine, Stanford University, Stanford, California, USA; Kristina Sundquist, MD, PhD, Center for Primary Health Care Research, Lund University, Malmö, Sweden, and Stanford Prevention Research Center, Stanford University, Stanford, California, USA; Marilyn A. Winkleby, PhD, Stanford Prevention Research Center, Stanford University, Stanford, California, USA; Jan Sundquist, MD, PhD, Center for Primary Health Care Research, Lund University, Malmö, Sweden, and Stanford Prevention Research Center, Stanford University, Stanford, California, USA.

出版信息

Br J Psychiatry. 2013 Sep;203(3):297-302. doi: 10.1192/bjp.bp.112.123992. Epub 2013 Aug 22.

DOI:10.1192/bjp.bp.112.123992

PMID:23969485

Abstract

BACKGROUND

Little is known about accidental death risks among psychiatric patients.

AIMS

To examine this issue in the most comprehensive study to date.

METHOD

National cohort study of all Swedish adults (n = 6 908 922) in 2001-2008.

RESULTS

There were 22 419 (0.3%) accidental deaths in the total population, including 5933 (0.9%) accidental deaths v. 3731 (0.6%) suicides among psychiatric patients (n = 649 051). Of persons who died from accidents, 26.0% had any psychiatric diagnosis v. 9.4% in the general population. Accidental death risk was four- to sevenfold among personality disorders, six- to sevenfold among dementia, and two- to fourfold among schizophrenia, bipolar disorder, depression or anxiety disorders, and was not fully explained by comorbid substance use. Strong associations were found irrespective of sociodemographic characteristics, and for different types of accidental death (especially poisoning or falls).

CONCLUSIONS

All mental disorders were strong independent risk factors for accidental death, which was substantially more common than suicide.

摘要

背景

关于精神科患者的意外死亡风险，人们知之甚少。

目的

在迄今最全面的研究中检验这一问题。

方法

对 2001-2008 年所有瑞典成年人（n=6908922）进行全国队列研究。

结果

在总人口中，有 22419 例（0.3%）意外死亡，包括 5933 例（0.9%）精神科患者的意外死亡和 3731 例（0.6%）自杀（n=649051）。在死于意外的人中，有 26.0%有任何精神科诊断，而在普通人群中为 9.4%。与一般人群相比，人格障碍者的意外死亡风险高出 4 至 7 倍，痴呆症患者高出 6 至 7 倍，精神分裂症、双相情感障碍、抑郁症或焦虑症患者高出 2 至 4 倍，且无法完全由合并物质使用来解释。无论社会人口特征如何，且对于不同类型的意外死亡（尤其是中毒或跌倒），均存在强烈的关联。