More than half of individuals living in a large metropolitan county in North Carolina who died suddenly outside the hospital had at least one diagnosed mental illness or substance use disorder in the previous five years, and more than one-third had two or more, according to a report in Psychiatric Services in Advance.
Among those with mental and/or substance use disorders, cardiovascular, respiratory, and metabolic conditions were common, wrote Jessica Ford, Ph.D., of the Department of Veterans Affairs in Greenville, N.D., and colleagues.
Ford and colleagues screened for sudden deaths attended by emergency medical services in Wake County, N.C., from March 1, 2013, to February 28, 2015. Deaths were considered sudden if the circumstances before death suggested an “abrupt pulseless condition” in the absence of any terminal disease (such as cancer or liver disease), drug overdoses, death from trauma, or other nonnatural cause.
Of 1,592 deaths that the researchers identified, there were 399 cases of sudden death. Of these, 270 had available medical records. The average age at death was 53. Chronic comorbid conditions, including hypertension, diabetes, coronary disease, and respiratory disease, were common among those with and without mental illness who died suddenly.
More than half (59%) of the individuals who died suddenly had at least one documented mental disorder or substance use disorder in their medical record, and 39% had more than one mental disorder or substance use disorder. Yet only 41% of the individuals had a documented referral to a mental health professional, and 33% had a documented visit with a mental health professional.
Although referrals to and treatment by mental health professionals were uncommon, almost one-half (46%) of individuals who died suddenly had prescriptions for psychotropic medications. Among those with mental illness, more than 75% of individuals had received prescriptions for psychotropic medications.
“The observed combination of mental disorders and medical conditions in sudden-death victims implies the need for collaborative care involving mental health and clinical professionals to help prevent sudden death among working-age adults,” Ford and colleagues concluded.
For related information, see the Psychiatric News article “Patients With Serious Mental Illness Need Better Primary Care Integration, Health Advocacy.”
(Image: iStock/Bim)
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