Retrospective analysis of the forensic autopsy cases of psychiatric patients.

This paper describes a retrospective analysis dealing with the sudden natural or unnatural death of psychiatric patients using actual autopsy findings, clinical information and demographic status. More than 70% of the 141 patients had schizophrenia, mood disorders or substance-related disorders. Accidental deaths were the most common (34.8%) and followed by natural deaths (28.4%), suicide (22.7%) and homicide (9.2%). Nearly half of mentally retarded patients died natural deaths, whereas two-thirds of patients with substance-related disorders died accidental deaths and about one-third of patients with schizophrenia and mood disorders committed suicide. Furthermore, patients with substance-related disorders were significantly more likely to live alone than were patients with schizophrenia or mood disorders. Twenty-five cases died in hospitals or other healthcare facilities; it is noteworthy that in the 12 patients who died natural deaths the reported symptoms had been less severe than might be expected and correct clinical diagnosis was not made before death. The present findings should be useful for both forensic pathologists and clinical psychologists.