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Causes and risk factors
Suicide, substance use and natural causes are respectively the most important causes of mortality in the first year post discharge from psychiatric hospitals
  1. Matthew Large,
  2. Sascha Swaraj
  1. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Dr Matthew Large, University of New South Wales, School of Psychiatry, Sydney NSW 2031, Australia; mmbl{at}

Statistics from

COMMENTARY ON: Walter F, Carr MJ, Mok PLH, et al. Premature mortality among patients recently discharged from their first inpatient psychiatric treatment. JAMA Psychiatry 2017;74:485–92.

What is already known on this topic

People with mental health conditions such as schizophrenia and mood or anxiety disorders have an elevated all-cause mortality.1 Those who have been admitted to psychiatric hospitals are at particular risk.2 Some of this increased mortality can be explained by suicides,3 but it is generally believed that the majority of the premature deaths of mentally ill people are from natural causes.1 However, suicide rates are alarmingly high in the year after discharge from psychiatric hospitals,4 but the relative contribution of suicide and natural death to premature mortality in this period is under-researched.

Methods of the study

The present study examined the relationship between the independent variable of psychiatric admission and dependent variables of all-cause mortality, natural mortality and mortality from unnatural causes (suicides, unintentional death and alcohol-related death) among Danish nationals born between 1967 and 1996 who were …

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  • Competing interests ML has given evidence about postdischarge deaths in coroners' matters and other legal cases. SS has no competing interests to declare.

  • Provenance and peer review Commissioned; internally peer reviewed.

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