The risk of pulmonary embolism in the context of various clinical situations and management in psychiatric patients
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Katedra i Klinika Psychiatryczna, Warszawski Uniwersytet Medyczny
Submission date: 2022-05-30
Final revision date: 2022-08-01
Acceptance date: 2022-08-02
Online publication date: 2023-10-31
Publication date: 2023-10-31
Corresponding author
Tadeusz Nasierowski   

Warszawski Uniwersytet Medyczny
Psychiatr Pol 2023;57(5):955-965
Pulmonary embolism (PE) and deep vein thrombosis are components of venous thromboembolism (VTE), being the third most common cardiovascular disease. PE is the most common life-threatening cardiovascular disorder, which is associated with mortality of 30% when managed incorrectly. Patients with mental disorders are at higher risk of thromboembolism as compared to general population and PE is commonly noted in this group. This mainly results from additional thromboembolic risk factors associated with symptoms and treatment of mental disorders. The scores recommended to estimate the VTE risk do not include factors typical of this group of patients. This article discusses how components of Virchow’s triad are activated by symptoms of mental disorders, i.e. psychosis, anxiety, depression and catatonia. The current state of knowledge on the thromboembolic risk associated with coercive measures that involve physical restraint of four limbs is presented. Current data on potentially thrombotic effect of antipsychotics, antidepressants and electroconvulsive therapy are summarised. Recommendations for the prevention of PE in patients with mental disorders are discussed.
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