Accidental and Homicidal Death in a Psychiatric Emergency Room Population
James R. Hillard M.D.1,
William W. K. Zung M.D.2,
Dietolf Ramm Ph.D.3,
Jacqueline M. Holland R.N.4, and
Matthiew Johnson M.D.5
1 The Department of Psychiatry at the University of Cincinnati Medical Center, Cincinnati, Ohio 45267
2 The Department of Psychiatry
3 The Department of Computer Science
4 The Department of Nursing Services at Duke University in Durham, North Carolina
5 The Department of Behavioral Medicine and Psychiatry at the University of Virginia in Charlottesville
To identify potentially preventable mortality other than suicide among psychiatric emergency room patients, the authors compared the rates of accidental and homicidal death among 5,284 consecutive psychiatric emergency room patients with those expected for an age-, sex-, and racematched sample of the general population. The rate of accidental death was two and one-half times and the rate of homicidal death nearly twice the expected ratefor the matchedgeneral population. Diagnostic and demographic analyses indicated that increased risk of death from either cause was highest among alcobolics, schizophrenic patients, and males. The implications of the findings for clinical care are discussed.
