Predictors of death from natural causes in schizophrenia: 10-year follow-up of a community cohort

Abstract

Active psychosis appears to predict natural mortality in people with schizophrenia. Mental health services should prioritise the effective treatment of psychosis. Further research is needed to clarify other risk factors and evaluate health promotion interventions.

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

“…Promoting physical activity and improving cardiorespiratory fitness may be a key intervention to reduce the overall and CVD-associated mortality in these patients (Vancampfort et al 2015). The studies included in our review, however, fail to address this issue: only one study analysed the influence of physical exercise on mortality (Brown et al 2012), though due to the limitations of data (patients reporting any physical activity may not necessarily do significant amount of exercise), the results were not conclusive enough. Whereas cardiorespiratory fitness as a separate variable has not been considered in the studies comprised in our review.…”

“…The risk of death was also significantly correlated with smoking (HR 2.53, 95% CI 1.01-6.34) and age on inclusion in the study (HR 1.08, 95% CI 1.02-1.13) for each additional year over 49.4 years (Brown et al 2012 …”

“…However, the majority of the studies failed to assess the influence of these conditions on mortality in schizophrenia: none of the studies took all the aforementioned risk factors into account, while the authors of only 7 of the papers considered at least one of them in their analyses. Three papers addressed hypertension and hyperlipidemia as specific risk factors (Schoepf et Only one study addressed physical inactivity (Brown et al 2012) and none took obesity into account as a specific risk factor.…”

“…In 10 years of observations, an increased risk of death for natural causes was related to active psychosis (HR 2.62, 95% CI 1.13-6.07) on enrolment into a study (Brown et al 2012). The risk of death was also significantly correlated with smoking (HR 2.53, 95% CI 1.01-6.34) and age on inclusion in the study (HR 1.08, 95% CI 1.02-1.13) for each additional year over 49.4 years (Brown et al 2012 …”

Mortality in Schizophrenia: Clinical and Serological Predictors

“…Persons with schizophrenia have elevations in 6 leading modifiable risk factors for mortality: smoking, hypertension, raised blood levels of glucose, physical inactivity, obesity, and dyslipidemia. 2,8 In addition, mortality in schizophrenia may be increased by drug and alcohol abuse, found to be disproportionately high in this population, as well as by suboptimal medical treatment and the overall social disadvantages experienced by many persons with the disorder. 5,9,10 Adverse effects of antipsychotic medications have also been identified as a cause of excess mortality in some but not other studies.…”