Avoidable mortality in people with schizophrenia or bipolar disorder in <scp>E</scp>ngland

Hoang, Uy; Goldacre, Michael J; Stewart, Robert

doi:10.1111/acps.12045

Cited by 99 publications

(77 citation statements)

References 21 publications

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“…For women included in the study during last 14 years, an increase in mortality gap (MG) was noted, versus a general female population in the same period. Hoang et al (2013) concluded that even if the health care availability to schizophrenia patients was improved, and suicide and open verdict cases prevention was the same as for a general population, the MG between schizophrenia patients and the general population would still exist. SMR would then drop from 4.23 (95% CI: 85-4.60) to 2.38 (95% CI: 2.09-2.66) in total, and from 4.55 (95% CI: 4.05-5.05) to 2.48 (95% CI: 2.11-2.85) for men and from 3.68 (95% CI: 3.11-4.24) to 2.16 (95% CI: 1.73-2.59) for women.…”

Section: Mortality Trends In European Studiesmentioning

confidence: 99%

Causes of Mortality in Schizophrenia: An Updated Review of European Studies

et al. 2017

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Section: Mortality Trends In European Studiesmentioning

confidence: 99%

Causes of Mortality in Schizophrenia: An Updated Review of European Studies

et al. 2017

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“…Although antipsychotics are the cornerstone of FES treatment 27 and reduce psychiatric symptoms and overall mortality, 28,29 they can cause cardiometabolic adverse effects 20,21 that should be prevented. 30 Unfortunately, little is known about the trajectory of cardiometabolic risk as patients progress through their illness. Further, FES data are scarce and largely limited to samples assessed in controlled trials and/or academic settings.…”

mentioning

confidence: 99%

Cardiometabolic Risk in Patients With First-Episode Schizophrenia Spectrum Disorders

et al. 2014

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IMPORTANCEThe fact that individuals with schizophrenia have high cardiovascular morbidity and mortality is well established. However, risk status and moderators or mediators in the earliest stages of illness are less clear.OBJECTIVE To assess cardiometabolic risk in first-episode schizophrenia spectrum disorders (FES) and its relationship to illness duration, antipsychotic treatment duration and type, sex, and race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS Baseline results of the Recovery After an Initial Schizophrenia Episode (RAISE) study, collected between July 22, 2010, and July 5, 2012, from 34 community mental health facilities without major research, teaching, or clinical FES programs. Patients were aged 15 to 40 years, had research-confirmed diagnoses of FES, and had less than 6 months of lifetime antipsychotic treatment. EXPOSURE Prebaseline antipsychotic treatment was based on the community clinician's and/or patient's decision. MAIN OUTCOMES AND MEASURES Body composition and fasting lipid, glucose, and insulin parameters. RESULTS In 394 of 404 patients with cardiometabolic data (mean [SD] age, 23.6 [5.0] years; mean [SD] lifetime antipsychotic treatment, 47.3 [46.1] days), 48.3% were obese or overweight, 50.8% smoked, 56.5% had dyslipidemia, 39.9% had prehypertension, 10.0% had hypertension, and 13.2% had metabolic syndrome. Prediabetes (glucose based, 4.0%; hemoglobin A 1c based, 15.4%) and diabetes (glucose based, 3.0%; hemoglobin A 1c based, 2.9%) were less frequent. Total psychiatric illness duration correlated significantly with higher body mass index, fat mass, fat percentage, and waist circumference (all P < .01) but not elevated metabolic parameters (except triglycerides to HDL-C ratio [P = .04]). Conversely, antipsychotic treatment duration correlated significantly with higher non-HDL-C, triglycerides, and triglycerides to HDL-C ratio and lower HDL-C and systolic blood pressure (all P Յ .01). Olanzapine was significantly associated with higher triglycerides, insulin, and insulin resistance, whereas quetiapine fumarate was associated with significantly higher triglycerides to HDL-C ratio (all P Յ .02). CONCLUSIONS AND RELEVANCEIn patients with FES, cardiometabolic risk factors and abnormalities are present early in the illness and likely related to the underlying illness, unhealthy lifestyle, and antipsychotic medications, which interact with each other. Prevention of and early interventions for psychiatric illness and treatment with lower-risk agents, routine antipsychotic adverse effect monitoring, and smoking cessation interventions are needed from the earliest illness phases.

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“…Individuals with schizophrenia have a drastically increased morbidity and mortality compared to members of the general public and the gap appears to be increasing (Hoang et al, 2013;Nielsen et al, 2013). Commonly occurring physical health conditions in this population include cardiovascular disease, metabolic syndrome, osteoporosis, obesity and diabetes (Cimo et al, 2012;Crump et al, 2013;De Hert et al, 2011).…”

Section: Introductionmentioning

confidence: 99%