Twenty-five year mortality of a community cohort with schizophrenia.
ABSTRACT People with schizophrenia have significantly raised mortality but we do not know how these mortality patterns in the UK have changed since the 1990s.
To measure the 25-year mortality of people with schizophrenia with particular focus on changes over time.
Prospective record linkage study of the mortality of a community cohort of 370 people with schizophrenia.
The cohort had an all-cause standardised mortality ratio of 289 (95% CI 247-337). Most deaths were from the common causes seen in the general population. Unnatural deaths were concentrated in the first 5 years of follow-up. There was an indication that cardiovascular mortality may have increased relative to the general population (P = 0.053) over the course of the study.
People with schizophrenia have a mortality risk that is two to three times that of the general population. Most of the extra deaths are from natural causes. The apparent increase in cardiovascular mortality relative to the general population should be of concern to anyone with an interest in mental health.
- SourceAvailable from: Tim Bradshaw06/2014; 2(2):166-182. DOI:10.3390/healthcare2020166
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ABSTRACT: Studies report contrasting results regarding the efficacy and safety of pharmacological, psychological, and combined interventions in psychosis and schizophrenia in children, adolescents and young adults. Systematic review and meta-analysis. Embase, Medline, PreMedline, PsycINFO, and CENTRAL were searched to July 2013 without restriction to publication status. Randomised trials comparing any pharmacological, psychological, or combined intervention for psychosis and schizophrenia in children, adolescents and young adults were included. Studies were assessed for bias, and GRADE criteria were used to describe the quality of the results. Twenty-seven trials including 3067 participants were identified. Meta-analyses were performed for 12 comparisons: symptoms, relapse, global state, psychosocial functioning, depression, weight and discontinuation. Low quality evidence demonstrated that antipsychotics have small beneficial effects on psychotic symptoms (SMD = -0.42, 95% CI -0.58 to -0.26), and a medium adverse effect on weight gain (WMD = 1.61, 95% CI 0.61 to 2.60) and discontinuation due to side effects (RR = 2.44, 95% CI, 1.12 to 5.31). There were no trials of psychological treatments in under-18 year olds. There was no evidence of an effect of psychological interventions on psychotic symptoms in an acute episode, or relapse rate, but low quality evidence of a large effect for family plus individual CBT on the number of days to relapse (WMD = 32.25, 95% CI -36.52 to -27.98). For children, adolescents and young adults, the balance of risk and benefit of antipsychotics appears less favourable than in adults. Research is needed to establish the potential for psychological treatments, alone and in combination with antipsychotics, in this population.PLoS ONE 01/2015; 10(2):e0117166. DOI:10.1371/journal.pone.0117166 · 3.53 Impact Factor
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ABSTRACT: Individuals with schizophrenia experience disparities in health based in part on negative perceptions of nurses. Attitudes and behaviors toward schizophrenia may improve when opportunities for interaction are increased.Clinical Simulation in Nursing 02/2015; 11(2):134-141. DOI:10.1016/j.ecns.2014.11.005