Risk of Cardiovascular Death Increased After Psychiatric Hospitalization

The rate of death due to heart-related problems is more than double the rate in the general population after psychiatric hospitalization.

Peter Simons
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Studies have found that the risk of death from suicide is up to 100 times greater than average after experiencing psychiatric hospitalization. However, other causes of death after hospitalization may also lead to the reduced lifespan of people diagnosed with mental health conditions.

A new study investigated the causes of death after psychiatric hospitalization and found that death due to cardiovascular (heart-related) events was highly increased in the mid-to-long term after hospitalization. One explanation for this increase is the prescription of psychiatric drugs, which have adverse effects on metabolism and cardiovascular health.

The study, published online in Acta Psychiatrica Scandinavica, was led by Matthew Large and Sascha Swaraj at the University of New South Wales, Australia.

Photo Credit: Pixabay

The researchers analyzed the data on mortality after psychiatric hospitalization from 71 previous studies, including data from 982,558 patients. They compared the number of premature deaths due to cardiovascular causes with the number of deaths from suicide in the short, medium, and long-term after leaving the hospital.

Although suicide rates are highly elevated after psychiatric hospitalization, cardiovascular deaths were even more elevated after about two years. Suicide rates diminished over time, while rates of vascular death increased. By the 10-year follow-up, cardiovascular deaths were three times as likely as deaths from suicide. The rate of cardiovascular mortality was more than twice as high as it is in the general population.

Although their study did not specifically investigate the reasons behind this drastic increase, there are numerous potential explanations. Among the two most prominent suggested by the authors: adverse effects of psychiatric medications, which are associated with metabolic and cardiovascular health problems; and mistreatment by doctors, who focus on the psychiatric diagnosis rather than improving the physical health of their patients.

According to the authors:

“The reasons for elevated rates of natural deaths among the seriously mentally ill are thought to include the side effects of psychotropic medication, self-neglect, lack of self-awareness regarding lifestyle behaviours influencing physical health, addictions such as smoking and alcohol, poor diet, diagnostic overshadowing of psychiatric conditions over physical conditions and under-treatment by medical care providers.”

 

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Swaraj, S., Chung, D., Curtis, J., Firth, J., Ramanuj, P. P., Sara, G., Wang, M., & Large, M. (2019). A meta-analysis of natural, unnatural, and cause-specific mortality rates following discharge from inpatient psychiatric facilities. Acta Psychiatrica Scandinavica. Published online, July 20, 2019. DOI: 10.1111/acps.13073 (Link)

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Peter Simons
MIA Research News Team: Peter Simons comes from a background in the humanities where he studied English, philosophy, and art. Now working on his PhD in Counseling Psychology, his recent research has focused on conflicts of interest in the psychopharmaceutical research literature, the use of antipsychotic medications in the treatment of depression, and the general philosophical and sociopolitical implications of psychiatric taxonomy in diagnosis and treatment.

4 COMMENTS

  1. The headline is misleading. The cohort studied were patients that had been psychiatrically hospitalized, and then were followed up at specific intervals. But they could just as easily have been patients in the community taking psychiatric drugs and followed up at the same intervals *if those records were available*. There is not even a correlation established between hospitalization and cardiac death because in order to do that there would have to have been a control group of non-hospitalized psychiatrically drugged patients followed up at the same intervals, and an increase in cardiac deaths seen *only in the hospitalized group*.

    In addition, the researcher bias is extremely strong with this statement:

    “The reasons for elevated rates of natural deaths among the seriously mentally ill are thought to include the side effects of psychotropic medication, self-neglect, lack of self-awareness regarding lifestyle behaviours influencing physical health, addictions such as smoking and alcohol, poor diet, diagnostic overshadowing of psychiatric conditions over physical conditions and under-treatment by medical care providers.”

    Pt complaints about side-effects are routinely dismissed, even as the patients balloon in weight, develop metabolic and cardiovascular diseases. Self-neglect is often a direct result of receiving neuroleptic drugs which are known to be neurotoxins that adversely effect cognition. Self-neglect is also perceived on the part of treatment staff who misinterpret the presentation of extreme poverty as poor self care. I can assure you that even people with so-called “SMI” are aware of the benefits of a good diet, of exercise, and of meditation/yoga/mindfulness/stress reduction etc. My favorite was when I was told I needed low impact exercise like swimming and tai chi. 😀 Where, dear doctor, do you suggest I obtain the magical funds to pay for all of this when my rent is more than my monthly disability check and I’m shopping the empty shelves at the food bank – hoping for ramen but coming away only with Easter candy this week. Nicotine addictions are known to be exacerbated by neuroleptic drugs so how fucking dare you. Alcohol and other drugs are used to cover up the pain of trauma – both the childhood variety and the adult “if you can’t slave for capitalism, you can rot in the streets” variety. And diagnostic shadowing of psychiatric conditions over physical conditions and poor medical care? You mean like undiagnosed Lyme Disease and wholesale dismissal of physical complaints as somatic?

    This is one of the most glaringly unscientific and victim blaming tropes I have seen on this site in a while. Please stop promoting pseudoscience as legitimate research,. You’re torturing the data!!! The only serious takeaway from this study is that psychiatric treatment has serious adverse long-term effects and the research, medical and political establishments are entirely blinkered on their participation in the continued mistreatment of those labeled as “seriously mentally ill”.

  2. Can they even track people who are on drugs but have never been hospitalized? Think of the massive amount of prescriptions out there, prescribed not only by psychiatrists, but by nurse practitioners, ob-gyn docs, neurologists, pain specialists, orthopedists, geriatric specialists, pediatricians, and more. It would be very hard to track down a fair sample.

    While likely hospitalization itself doesn’t directly cause cardiac death, indirectly, it does. During hospitalization patients are brainwashed into believing they have real diseases that will require “medication adherence…” which in turn, kills them.