Declaration of interest
Little is known about accidental death risks among psychiatric patients.
To examine this issue in the most comprehensive study to date.
National cohort study of all Swedish adults (n = 6 908 922) in 2001-2008.
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).
All mental disorders were strong independent risk factors for accidental death, which was substantially more common than suicide.
This work was supported by grants from the National Institute of Drug Abuse [R01DA030005], the Swedish Research Council, and ALF project grant, Lund, Sweden. The funding agencies had no role in the design and conduct of the study; in the collection, analysis and interpretation of the data; or in the preparation, review or approval of the manuscript.
- Royal College of Psychiatrists