Mental disorders and risk of accidental death

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.