The paradox of premature mortality in schizophrenia: new research questions

Abstract

The life expectancy of patients with schizophrenia is reduced by between 15 and 25 years. Those patients dying of natural causes die of the same diseases as in the general population. In 2009 the World Health Organization (WHO) identified underlying global risk factors for mortality in the general population. However, there is little evidence in the literature assessing their validity in those with schizophrenia. The WHO report on global health risks (2009) identifies hypertension, smoking, raised glucose, physical inactivity, overweight and obesity, and high cholesterol as the six leading global mortality risk factors. Currently, there are minimal data on the contribution to mortality that these risk factors make in schizophrenia, and their optimum management. Both short and long-term studies are needed to address these gaps. New research has raised important questions about risk balance with regards to ideal body mass, with some studies showing that being overweight is associated with lower all-cause mortality and lower suicide rates. Cardiorespiratory fitness is being recognized as a more powerful predictor of mortality than smoking, hypertension or diabetes in men. However, there are virtually no published data on assessment of fitness levels in schizophrenia. New studies have raised concerns about the quality of physical care for patients with schizophrenia, which is another important avenue of future research. A greater biological understanding of the relationship between these disorders and schizophrenia would inform clinical practice. Low birth weight has been associated with increased risk for schizophrenia, and it will be important to explore this risk factor for both physical and mental health outcomes.

Oral Health Is a Challenging Problem for Patients with Schizophrenia: A Narrative Review

“…In essence, schizophrenia means patients are not always able to perceive their health problems and this causes them to make the wrong decisions when it comes to resolving them on their own (4). This involves the coexistence of mental disorders with numerous organic co-morbidities, including the classic metabolic syndrome (diabetes, hypertension, dyslipidemia, and abdominal obesity) (5)(6)(7). Not to mention malnutrition, poor health practices, and antipsychotic treatments, which are the side effects that combine with all the co-morbidities to which they are exposed (8).…”

Poles apart: does the export of mental health expertise from the Global North to the Global South represent a neutral relocation of knowledge and practice?

“…), while long‐term use of second‐generation drugs raises the risk of physical illnesses and shortened life expectancy (Wildgust et al . , Casey et al . , Chang et al .…”

Physical health and well‐being: Experiences and perspectives of young adult mental health consumers

“…People with mental illness often experience compromised physical health, and life expectancy for this group is typically reduced by 15–20 years (Thornicroft ; Wildgust et al . ). Increased cardiometabolic health problems and cardiovascular disease (CVD) account for much of the morbidity and mortality in adults with severe mental illness (Gladigau et al .…”