{"title":"Foreseeably Early Deaths in Patients With Psychiatric Disorders: Challenges in Caring for Patients Manifesting Likely Fatal Trajectories.","authors":"Joel Yager, Jonathan Treem, Thomas B Strouse","doi":"10.1097/NMD.0000000000001789","DOIUrl":null,"url":null,"abstract":"<p><strong>Abstract: </strong>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.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nervous and Mental Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NMD.0000000000001789","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
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.
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.