Death certification in a psychiatric hospital

Abstract

Aims and methodA retrospective review of death certificates issued at a large psychiatric hospital in North Cheshire during the 1980s and 1990s.ResultsDementia, which was the recorded clinical diagnosis in 78% of all deceased, was reported in 31% of death certificates, while other psychiatric disorders (22% of all deceased) appeared in only 2% of certificates. Autopsy appears to have very little or no value in improving the quality of death certificates in psychiatry.Clinical implicationsThe onus is on the clinicians to produce adequate death certificates. Recording chronic conditions present at death, such as dementia and other psychiatric disorders, in addition to those directly causing or contributing to death would improve the epidemiological value of death certificates.