Mortality among patients with schizophrenia and reduced psychiatric hospital care

Heilä, Hannele; Haukka, Jari; Suvisaari, Jaana; Lönnqvist, Jouko

doi:10.1017/s0033291704004118

Cited by 96 publications

(75 citation statements)

References 19 publications

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“…The higher risk of mortality in males compared to females, especially in the first years after the onset of the disorder, might also contribute to explaining the finding of different incidences, although with comparable prevalence in the two sexes (Joukamaa et al, 2001;Heilä et al, 2005). Overall, sex differences among patients with schizophrenia include age of onset, symptoms severity at presentation, treatment response, course of illness and outcome (Grossman et al, 2006;Häfner, 2003;Tamminga, 1997).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in first-episode psychosis and in people at ultra-high risk

Cocchi¹,

Lora²,

Meneghelli³

et al. 2014

Psychiatry Research

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Section: Introductionmentioning

confidence: 99%

Sex differences in first-episode psychosis and in people at ultra-high risk

Cocchi¹,

Lora²,

Meneghelli³

et al. 2014

Psychiatry Research

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“…While suicide is usually associated with depression, the relative risk of death from suicide is increased nearly 10-fold in schizophrenia and 50-fold in anorexia nervosa. 8,9 What is perhaps most surprising in looking at morbidity and mortality data is that we have made so little progress on some of the most serious mental disorders. While we are seeing recent reductions in deaths from cardiac disease, AIDS, certain cancers, and even homicide, the mortality rate as measured by the number of suicides has changed little in the past century.…”

Section: Introductionmentioning

confidence: 99%

Cure therapeutics and strategic prevention: raising the bar for mental health research

2005

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Mental disorders cause more disability than any other class of medical illness in Americans between ages 15 and 44 years. The suicide rate is higher than the annual mortality from homicide, AIDS, and most forms of cancer. In contrast to nearly all communicable and most non-communicable diseases, there is little evidence that the morbidity and mortality from mental disorders have changed in the past several decades. Mental health advocates, including psychiatric researchers, have pointed to stigma as one of the reasons for the lack of progress with mental illnesses relative to other medical illnesses. This review considers how the expectations and goals of the research community have contributed to this relative lack of progress. In contrast to researchers in cancer and heart disease who have sought cures and preventions, biological psychiatrists in both academia and industry have set their sights on incremental and marketable advances, such as drugs with fewer adverse effects. This essay argues for approaches that can lead to cures and strategies for prevention of schizophrenia and mood disorders.

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“…3,4 The risk is particularly high in the first episode of the illness and decreases with time after the first hospital admission. 5 Different studies, using different populations and methods, have yielded varying estimates of the suicide rate in schizophrenia. 6,7 While earlier research has suggested that up to 13% of patients with schizophrenia commit suicide, 2 more recent studies that take into account the variable suicide risk during the life span (a higher risk close to illness onset and thereafter a declining risk) have reported a lifetime suicide mortality of 4%-5%.…”

mentioning

confidence: 99%

Completed and Attempted Suicides Among 18,154 Subjects With Schizophrenia Included in a Large Simple Trial

Fleischhacker¹,

Kane²,

Geier³

et al. 2014

J. Clin. Psychiatry

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Objective:To characterize subgroups of subjects with schizophrenia from the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC) trial who either completed or attempted suicide and those who did not.Method: The ZODIAC, conducted between February 2002 and March 2007, was an open-label, randomized, large simple trial of patients with schizophrenia (N = 18,154) followed up for 1 year by unblinded investigators providing usual care in 18 countries; the primary outcome measure was nonsuicide mortality. Every report on a completed or attempted suicide was independently adjudicated using a predefined algorithm. Primary analysis for the current report examined the association between completed or attempted suicides and the baseline variables using descriptive statistics and multivariate logistic regression models. Usage of "hard" or "soft" methods for attempted or completed suicide and distribution of suicide-related events by geographical region were also summarized. Results:Overall incidences of subjects who either completed (35/18,154) or attempted (108/18,154) suicide were low, as were rates per person-time on assigned treatment analysis (0.24 for completed and 0.74 for attempted suicides per 100 person-years of exposure). The highest suicide-related mortality was seen among subjects recently diagnosed with schizophrenia. Among all potential baseline risk factors for completed suicide examined, the variables most associated with completed suicide were history of suicide attempts (OR = 2.6; 95% CI, 1.33-5.12) and usage of antidepressant medication (OR = 3.5; 95% CI, 0.84-14.85). History of > 5 hospitalizations in the past (OR = 2.1; 95% CI, 1.35-3.31) and history of suicide attempts (OR = 5.0; 95% CI, 3.21-7.76) were the variables most associated with attempted suicide among potential baseline risk factors for suicide attempts. Conclusions:Our results, obtained in a large prospective randomized study, confirm current clinical understanding regarding completed or attempted suicide in schizophrenia and the associated risk factors. Suicide is a major cause of death among patients with schizophrenia, 1 with lifetime prevalence estimates over 10 times higher than the general population 2 and a relatively higher suicide risk found in younger age groups of patients.3,4 The risk is particularly high in the first episode of the illness and decreases with time after the first hospital admission. 5 Different studies, using different populations and methods, have yielded varying estimates of the suicide rate in schizophrenia. 6,7 While earlier research has suggested that up to 13% of patients with schizophrenia commit suicide, 2 more recent studies that take into account the variable suicide risk during the life span (a higher risk close to illness onset and thereafter a declining risk) have reported a lifetime suicide mortality of 4%-5%. 6-9 Nevertheless, this figure remains significantly higher than estimates for the general population, with the mortality gap between the 2 populations increasing over the la...

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Mortality among patients with schizophrenia and reduced psychiatric hospital care

Cited by 96 publications

References 19 publications

Sex differences in first-episode psychosis and in people at ultra-high risk

Sex differences in first-episode psychosis and in people at ultra-high risk

Cure therapeutics and strategic prevention: raising the bar for mental health research

Completed and Attempted Suicides Among 18,154 Subjects With Schizophrenia Included in a Large Simple Trial

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