Obstructive asphyxia: a cause of excess mortality in psychiatric patients

Corcoran, Elizabeth; Walsh, Dermot

doi:10.1017/s079096670000776x

Cited by 20 publications

(20 citation statements)

References 11 publications

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“…Possible, yet sparsely researched, causal factors include institutional conditions, symptoms of the mental illness itself, and neurologic disorders in patients with mental health disorders [2] (e.g., functional imaging studies indicate cerebral changes associated with symptoms of schizophrenia [20]). Not only do these various causes need to be considered in terms of the medical sequelae of both dysphagia and aspiration, they must also be acknowledged in terms of the prevalence of choking episodes within this population [5].…”

Section: Discussionmentioning

confidence: 99%

“…Other studies [3] have reported that choking while drinking or eating, termed cafe´coronaries [4], had long been recognized within the mental health disorder population. Indeed, a recent study [5] reports that the rate of death due to asphyxia in psychiatric inpatients in Ireland was 0.85/1000 in 1982 [6]. This rate contrasts with the 100 times lower rate of 0.66/100,000 in the general population [7].…”

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confidence: 99%

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Prevalence of Dysphagia in Acute and Community Mental Health Settings

2006

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The incidence of dysphagia in the population with mental health disorders may be higher as a result of a number of factors including the nature of the psychiatric disorder, effects of psychiatric medications, co-occurring neurologic conditions, and institutionalization and behavioral changes associated with the mental illness. This study aimed to determine the prevalence of dysphagia among adults with mental health disorders (MHDs) who attend acute and community mental health settings. Sixty attenders at a local area psychiatric service were assessed using a simple swallowing screening test. Subjects presented with a variety of mental health disorders and were attending an acute inpatient unit, day hospital, or long-term care setting. Thirty-two percent of those assessed demonstrated overt signs of oropharyngeal dysphagia. There was an increased prevalence in the inpatient unit (35%); the lowest prevalence of dysphagia was in those attending the day hospitals (27%). Thirty-one percent of those attending long-term care settings also had dysphagic symptoms. Twenty-three percent of individuals with schizophrenia in the total group had oropharyngeal dysphagia; this figure rose to 31% in the inpatient unit. Twenty-seven percent of individuals with bipolar affective disorder (BPAD) demonstrated overt signs of oropharyngeal dysphagia. Each of these individuals with BPAD was in an inpatient setting. The results of this study provide evidence to suggest that there is an increased incidence of dysphagia in those with mental health disorders. Of particular interest is the marked proportion (approximately one third) of those attending acute and long-term care settings with dysphagia. Possible contributing factors are discussed.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Prevalence of Dysphagia in Acute and Community Mental Health Settings

2006

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“…Table 3 shows how each clinical sign was distributed among subjects in both groups. study and other published papers are due both to the methods for evaluating swallowing and to observing carefully the relationship between food consistency and clinical signs [5][6][7][8][9][10][11]19,21,[23][24][25] . Therefore, while one of those studies found changes in 30% of subjects, and another found changes in 90% of subjects, we encountered no significant effect of neuroleptic drugs on swallowing 7,11 .…”

Section: Resultsmentioning

confidence: 99%

Bedside assessment of swallowing in elderly subjects using psychotropic drugs

Fioravanti

Miyahara

Cavallari

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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Neurol eptic drugs are used in several mental disorders, but are suspected of causing oropharyngeal dysphagia, mainly in the elderly. Aim:To study the effect of neuroleptic agents on swallowing of institutionalized older people. Material and method:A cross sectional study of swallowing in 47 subjects that either used or did not use neuroleptic drugs. Bedside swallowing tests with foods of four different consistencies were carried out.Results: There was no significant difference between the two groups. Users of neuroleptic medications showed a higher percentage of multiple swallowing while non-users had a higher percentage of oral food escape. Conclusion:Neuroleptic agents alone do not affect the mechanism of swallowing in the elderly; nonetheless. Further studies with a larger number of individuals and specific swallowing tests are needed.ORIGINAL ARTICLE Braz J Otorhinolaryngol. 2011;77(4):526-30. BJORL

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“…In one of these studies [20], 0.7% of a psychiatric hospital's deaths over 8 years could be attributed to this cause. The other two studies reported proportions of 3.3% over a 6-year period [19] and 6% over a 10-year period [21]. The remaining 7-year study that analysed an entire population of an Australian state concluded that the relative risk of adults with schizophrenia dying from this cause was 30 times that of the general population, and that adults with an organic mental disorder (a mental disorder with a demonstrable aetiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction [22]) were 43 times more likely to die from this cause than the general population [8].…”

Section: Frequency Of Asphyxiation Death Due To Choking On Foodmentioning

confidence: 93%

Dysphagia is a Common and Serious Problem for Adults with Mental Illness: A Systematic Review

Aldridge

Taylor

2011

Dysphagia

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Adults with mental illness may experience a higher incidence of dysphagia and choking due to factors such as medication side effects and behavioural abnormalities. The aim of this study was to determine the frequency of dysphagia and the most effective interventions for this population. Studies published up to August 2010 were sought via a comprehensive electronic database search (CINAHL, PsycINFO, MEDLINE, PubMed, Cochrane, and Embase). Studies reporting dysphagia frequency or dysphagia intervention outcomes in adults with mental illness were included. Two reviewers independently assessed study eligibility and quality, and the results were synthesised descriptively. Ten studies were identified, each describing dysphagia frequency or death due to choking asphyxiation. No studies evaluating intervention effectiveness were identified. Study quality was limited by subjective assessment of outcomes. Six studies presented dysphagia frequencies ranging from 9 to 42% in varying subgroups. Four studies presented the frequency of choking asphyxiation death, including a large survey that concluded that adults with organic mental illness were 43 times more likely to die of this cause than the general population. Dysphagia is a common and significant cause of morbidity and mortality in adults with mental illness and our review found that there is a lack of studies evaluating the effectiveness of intervention techniques.

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Obstructive asphyxia: a cause of excess mortality in psychiatric patients

Abstract: The purpose of this study was to determine the number of deaths which were caused by choking in a 10 year period in the Irish psychiatric in-patient population and the factors associated with such deaths.

Cited by 20 publications

References 11 publications

Prevalence of Dysphagia in Acute and Community Mental Health Settings

Prevalence of Dysphagia in Acute and Community Mental Health Settings

Bedside assessment of swallowing in elderly subjects using psychotropic drugs

Dysphagia is a Common and Serious Problem for Adults with Mental Illness: A Systematic Review

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