Excess Early Mortality in Schizophrenia

Abstract

Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality as well as possible ways to reduce it. Persons with schizophrenia have an exceptionally short life expectancy. High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population. Evidence suggests that persons with schizophrenia may not have seen the same improvement in life expectancy as the general population during the past decades. Thus, the mortality gap not only persists but may actually have increased. The most urgent research agenda concerns primary candidates for modifiable risk factors contributing to this excess mortality, i.e., side effects of treatment and lifestyle factors, as well as sufficient prevention and treatment of physical comorbidity.

Analyses of Heart Rate, Respiration and Cardiorespiratory Coupling in Patients with Schizophrenia

“…These patients have an approximately 15 to 20-year shorter life expectancy and a relatively high risk for attaining cardiovascular disease (CVD); a three-fold increase in comparison to the general population has been reported for all age groups [1][2][3]. The largest single cause of death in schizophrenia leading to increased mortality is due to CVD, with CVD mortality ranging from 40% to 50% [4].…”

Strategies for preventing excess mortality after discharge from psychiatric emergency room.

“…Increased awareness of physical morbidity in this risk group must be assured, as well as securing continuity in treatment for this group after visiting psychiatric emergency room. Previous studies have revealed that excess mortality peaks the first year after the patients are discharged from psychiatric emergency room 15 . When psychiatric patients visits a psychiatric emergency room it presents as a rare opportunity to perform a physical examination to search for early disease 10 .…”

Managing complex long-term conditions and multimorbidity

“…19 Schizophrenia is associated with a reduced life expectancy of 11-20 years . 20 Factors like reduced motivation, side effects from psychotropic medications and an unhealthy lifestyle -including smoking, poor diet, excess alcohol -may contribute to this. Intrauterine environment and childhood adversity play a role.…”