Centre for Disability Research and Policy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2023 Feb;58(2):239-248. doi: 10.1007/s00127-022-02280-4. Epub 2022 May 3.
People with mental illness are a vulnerable and stigmatised group with poor health outcomes including greater premature mortality. This study aimed to investigate trends and rates of change in unintentional drug-related deaths for people with mental illness, describe types of medicines involved, and identify populations at risk in a cohort from New South Wales, Australia.
Features of unintentional drug-related deaths for people with mental illness between 2012 and 2016 were identified in a retrospective review of data from the National Coronial Information System.
A total of 495 unintentional drug-related deaths were identified (1.6 deaths/100,000 population), showing an upward trend (p < 0.01). The most common substance involved was diazepam in both genders (males 135/319, 42%, female 76/176, 43%) and more than one contributory drug was included in 80% of cases. Between 2012 and 2016, amphetamine-related deaths showed the highest increase (3.2-fold), followed by codeine (2.5-fold) and quetiapine (2.5-fold). Males (RR 1.8, 95% CI 1.5-2.2) and people aged 35-44 (RR 1.7, CI 1.3-2.2) were more likely to die from unintentional drug-related deaths compared with the reference (females and people aged 25-34).
This study found that the drugs commonly involved in deaths are also the drugs commonly used by and prescribed to people with mental illness. There were also significant differences between gender, age group, and marital status in the trend and rate of unintentional drug-related deaths for people with mental illness. A multifaceted approach encompassing both pharmaceutical prescribing and targeted public health messaging is required to inform intervention and prevention strategies.
精神疾病患者是一个脆弱且受歧视的群体，他们的健康状况较差，包括过早死亡率更高。本研究旨在调查澳大利亚新南威尔士州队列人群中精神疾病患者非故意药物相关死亡的趋势和变化率，描述涉及的药物类型，并确定高危人群。
通过对国家验尸信息系统数据的回顾性审查，确定了 2012 年至 2016 年期间精神疾病患者非故意药物相关死亡的特征。
共确定了 495 例非故意药物相关死亡（每 10 万人中有 1.6 例死亡），呈上升趋势（p<0.01）。在男女两性中最常见的涉及物质均为地西泮（男性 319 例中有 135 例，42%；女性 176 例中有 76 例，43%），80%的病例中包含不止一种促成药物。在 2012 年至 2016 年期间，与安非他命相关的死亡人数增长最快（增加了 3.2 倍），其次是可待因（增加了 2.5 倍）和喹硫平（增加了 2.5 倍）。与参照（女性和 25-34 岁人群）相比，男性（RR 1.8，95%CI 1.5-2.2）和 35-44 岁人群（RR 1.7，CI 1.3-2.2）更有可能死于非故意药物相关死亡。
本研究发现，死亡中常见的药物也是精神疾病患者常用和开的药物。精神疾病患者非故意药物相关死亡的趋势和发生率在性别、年龄组和婚姻状况方面也存在显著差异。需要采取多方面的方法，包括药物处方和有针对性的公共卫生宣传，以告知干预和预防策略。
