The end of fragmented consciousness: deaths in schizophrenia—an autopsy-based study

BACKGROUND: Deaths in schizophrenia are multifactorial, yet postmortem data from Türkiye are limited. This study evaluated demographic, clinical, and postmortem characteristics of patients with schizophrenia, with particular focus on antipsychotic use, death circumstances, and organ pathology. METHOD: A retrospective analysis was conducted on 107 autopsy cases from 2020 to 2024. Data on demographics, clinical history, toxicology, and macroscopic organ findings were collected and analyzed. RESULTS: Most patients were male (70.1%) with a mean age of 50 ± 13.8 years. Natural deaths accounted for 56.1%, predominantly cardiovascular, whereas non-natural deaths comprised 43.9%, mainly trauma and asphyxia. Antipsychotics were detected in 61.3% of cases, often in combination, and antidepressants in 21.7%. Combined antipsychotic use was associated with a lower likelihood of being found dead. CONCLUSION: Deaths in schizophrenia are influenced by cardiovascular, traumatic, metabolic, and pharmacological factors. Postmortem evaluations indicate limited macroscopic effects of psychotropic medications. Mortality risk assessment should integrate clinical, pharmacological, and sociodemographic factors.