Analysis of risk factors for schizophrenia with two different case definitions: A nationwide register-based external validation study

Sørensen, Holger J.; Larsen, Janne Tidselbak; Mors, Ole; Nordentoft, Merete; Mortensen, Preben Bo; Petersen, Liselotte

doi:10.1016/j.schres.2015.01.018

Cited by 8 publications

(4 citation statements)

References 30 publications

(30 reference statements)

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“…Previous studies have found excess mortality to be highest the year following a first diagnosis of severe mental illness, due to increased mortality from unnatural causes of death [ 2 , 65 ]. Besides low expected death rates in the youngest in the general population, the inverse relationship between the SMR and age may thus partly be explained by the inclusion of presumably more incident cases in the youngest and more prevalent cases among the oldest in our study, and may have been amplified by survivor bias, treatment-compliant patients in our sample and lower suicide rates with increasing age in SCZ patients [ 66 ]. Comorbid women did not, however, experience a decrease in SMR with increasing age, but had very high mortality across all age groups.…”

Section: Discussionmentioning

confidence: 99%

Total and cause-specific standardized mortality ratios in patients with schizophrenia and/or substance use disorder

Heiberg¹,

Jacobsen

Nesvåg

et al. 2018

PLoS ONE

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Individuals with schizophrenia or substance use disorder have a substantially increased mortality compared to the general population. Despite a high and probably increasing prevalence of comorbid substance use disorder in people with schizophrenia, the mortality in the comorbid group has been less studied and with contrasting results. We performed a nationwide open cohort study from 2009 to 2015, including all Norwegians aged 20–79 with schizophrenia and/or substance use disorder registered in any specialized health care setting in Norway, a total of 125,744 individuals. There were 12,318 deaths in the cohort, and total, sex-, age- and cause-specific standardized mortality ratios (SMRs) were calculated, comparing the number of deaths in patients with schizophrenia, schizophrenia only, substance use disorder only or a co-occurring diagnosis of schizophrenia and substance use disorder to the number expected if the patients had the age-, sex- and calendar-year specific death rates of the general population. The SMRs were 4.9 (95% CI 4.7–5.1) for all schizophrenia patients, 4.4 (95% CI 4.2–4.6) in patients with schizophrenia without substance use disorder, 6.6 (95% CI 6.5–6.8) in patients with substance use disorder only, and 7.4 (95% CI 7.0–8.2) in patients with both schizophrenia and substance use disorder. The SMRs were elevated in both genders, in all age groups and for all considered causes of death, and most so in the youngest. Approximately 27% of the excess mortality in all patients with schizophrenia was due to the raised mortality in the subgroup with comorbid SUD. The increased mortality in patients with schizophrenia and/or substance use disorder corresponded to more than 10,000 premature deaths, which constituted 84% of all deaths in the cohort. The persistent mortality gap highlights the importance of securing systematic screening and proper access to somatic health care, and a more effective prevention of premature death from external causes in this group.

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Section: Discussionmentioning

confidence: 99%

Total and cause-specific standardized mortality ratios in patients with schizophrenia and/or substance use disorder

Heiberg¹,

Jacobsen

Nesvåg

et al. 2018

PLoS ONE

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“…Potential confounders were identified a priori based on previous literature that suggested associations with both asthma and bipolar disorder or schizophrenia spectrum disorder risk. We included sex, birth order, 23 socioeconomic status (SES) (defined as quintile of family income at birth, based on the whole population of Sweden), 24–26 urban or rural residency, 27,28 whether the mother was Swedish born, preterm delivery, 29,30 antenatal infections, 14 childhood respiratory infections before the age of 6 (using codes included in supplementary table 1), maternal and paternal age, 31–33 maternal and paternal asthma admissions before the child was born (for mutually adjusted models), 34 and parental history of SMI (including inpatient diagnoses of bipolar disorder, schizophrenia, schizoaffective disorder, and other nonaffective nonorganic psychoses). 35 Age and calendar year were included as time-varying covariates.…”

Section: Methodsmentioning

confidence: 99%

Childhood and Parental Asthma, Future Risk of Bipolar Disorder and Schizophrenia Spectrum Disorders: A Population-Based Cohort Study

Dalman

Karlsson

et al. 2018

Schizophrenia Bulletin

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As far as we are aware, this is the first study to find increased risk of bipolar disorder in children of individuals with asthma. Asthma admissions before aged 11 do not appear to be linked to bipolar or schizophrenia spectrum disorders. Taken together, our results do not suggest a straightforward link between asthma and severe mental illness via neurodevelopmental effects of inflammation, but potentially there is shared genetic vulnerability. This finding has implications for understanding the differential pathogenic mechanisms of bipolar and schizophrenia spectrum disorders.

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“…Antipsychotics increased from the first to the second observation period significantly. The presence of these types of psychotropic medication when found in the toxicological screening following overdose deaths have been shown to be associated with mental illness [26]. It is possible that some decedents had kept medication from earlier treatment and thus were known to have been suffering from a mental illness.…”

Section: Temporal Observationsmentioning

confidence: 99%

Psychiatric disorders in a population of deceased drug users

Kruckow

Tjagvad

Clausen

et al. 2021

Nordic Journal of Psychiatry

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Purpose: To estimate the prevalence of psychiatric morbidity and dual diagnosis in a population of decedents with positive drug toxicology and evaluate changes over time between 2001-2002 and 2011-2012. Materials and methods: A total of 520 autopsied drug users with positive toxicology were included in the study from 2001 to 2002 and from 2011 to 2012. Materials included autopsy reports, toxicological screening during autopsy and data from the Danish national health registers, including psychiatric diagnoses from psychiatric hospitals and ambulatory functions, dispensed prescription use from pharmacies and registered treatment for drug use disorders. Results: In 2001-2002, 63.3% of the decedents had only positive toxicology, 22.5% also had psychiatric morbidity, and 14.2% had a dual diagnosis. In 2011-2012, 56.4% had only positive toxicology, 26.1% also had psychiatric morbidity, and 17.5% had a dual diagnosis. None of the changes were significant. Decedents with only positive toxicology became older at time of death over time; decedents with psychiatric morbidity and a dual diagnosis did not. The prevalence of nonprescribed psychotropic medication, methadone and benzodiazepines increased. Conclusion: Decedents with psychiatric morbidity and dual diagnosis did not increase their lifespan over a 10-year period. Decedents with only positive toxicology increasingly consumed nonprescribed psychotropic medication and may have suffered from undiagnosed psychiatric disorders. The prevalence of prescribed and nonprescribed benzodiazepines and methadone increased and may have contributed to premature mortality.

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Analysis of risk factors for schizophrenia with two different case definitions: A nationwide register-based external validation study

Cited by 8 publications

References 30 publications

Total and cause-specific standardized mortality ratios in patients with schizophrenia and/or substance use disorder

Total and cause-specific standardized mortality ratios in patients with schizophrenia and/or substance use disorder

Childhood and Parental Asthma, Future Risk of Bipolar Disorder and Schizophrenia Spectrum Disorders: A Population-Based Cohort Study

Psychiatric disorders in a population of deceased drug users

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