Foreseeably Early Deaths in Patients With Psychiatric Disorders: Challenges in Caring for Patients Manifesting Likely Fatal Trajectories.

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY Journal of Nervous and Mental Disease Pub Date : 2024-09-01 DOI:10.1097/NMD.0000000000001789
Joel Yager, Jonathan Treem, Thomas B Strouse
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Abstract

Abstract: Patients with psychiatric disorders often have foreshortened lives, attributed both to "natural" medical and "unnatural" external causes of death such as suicide, homicide, and accident. Many deaths are foreseeable due to circumstances linked to patients' psychiatric disorders. These can include illness-associated disparities, adverse treatment effects, lack of self-care, and behaviors stemming directly from psychopathological processes. Whereas some of these processes contribute indirectly to patients' causes of death, others are more directly consequential, causing patients to "die from" their psychiatric disorders. Some patients manifest likely fatal trajectories that may lead to "end-stage" psychiatric disorders. Palliative approaches may optimize their quality of life and potentially alter these trajectories, but patients with psychiatric disorders are less likely to receive optimal end-of-life care. Although assuring a "good death" can be challenging, systematic efforts can assist in providing patients with psychiatric disorders deaths with dignity rather than indignity.

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精神病患者的可预见早期死亡:护理表现出可能致命轨迹的患者所面临的挑战。
摘要:精神障碍患者通常会缩短生命,其原因既有 "自然 "的医疗死亡,也有 "非自然 "的外部死亡,如自杀、他杀和意外事故。许多死亡是可以预见的,原因是与患者的精神障碍有关。这些情况包括与疾病相关的差异、不良治疗效果、缺乏自我护理以及直接源于精神病理过程的行为。这些过程中,有些是间接导致患者死亡的原因,有些则是更直接的后果,导致患者 "死于 "精神障碍。有些患者表现出可能导致精神障碍 "终末期 "的致命轨迹。姑息治疗方法可以优化他们的生活质量,并有可能改变这些轨迹,但精神障碍患者不太可能获得最佳的临终关怀。尽管确保 "美好的死亡 "可能具有挑战性,但系统性的努力可以帮助精神障碍患者有尊严地死亡,而不是无尊严地死亡。
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来源期刊
CiteScore
2.90
自引率
5.30%
发文量
233
审稿时长
3-8 weeks
期刊介绍: The Journal of Nervous and Mental Disease publishes peer-reviewed articles containing new data or ways of reorganizing established knowledge relevant to understanding and modifying human behavior, especially that defined as impaired or diseased, and the context, applications and effects of that knowledge. Our policy is summarized by the slogan, "Behavioral science for clinical practice." We consider articles that include at least one behavioral variable, clear definition of study populations, and replicable research designs. Authors should use the active voice and first person whenever possible.
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