Twenty-five year mortality of a community cohort with schizophrenia

Hampshire Partnership NHS Trust, Southampton, UK.
The British journal of psychiatry: the journal of mental science (Impact Factor: 7.99). 02/2010; 196(2):116-21. DOI: 10.1192/bjp.bp.109.067512
Source: PubMed


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.

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    • "It is recognized that individuals suffering from schizophrenia have a greater prevalence of the metabolic syndrome (De Hert, Dekker et al. 2009, De Hert, Schreurs et al. 2009, Mitchell, Vancampfort et al. 2013), and premature mortality (Saha et al., 2007, McGrath et al., 2008) with a reduced life expectancy of about 20% compared with the general population (Newman and Bland 1991; Hausswolff-Juhlin et al., 2009). The leading natural cause of death in patients with schizophrenia is cardiovascular disease (Hennekens 2006; Brown et al., 2010). However, the cause-effect relationships in this context are not straightforward (Hausswolff-Juhlin, Bjartveit et al. 2009). "
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    ABSTRACT: Method: We collected MRI structural scans in 14 first-episode schizophrenia patients with either self-reported low or high physical activity levels. We found a reduction in total gray matter volume, prefrontal cortex (PFC), and hippocampal gray matter volumes in the low physical activity group compared to the high activity group. Cortical thickness in the dorsolateral and orbitofrontal PFC were also significantly reduced in the low physical activity group compared to the high activity group. In the combined sample, greater overall physical activity levels showed a non-significant tendency with better performance on tests of verbal memory and social cognition. Together these pilot study findings suggest that greater amounts of physical activity may have a positive influence on brain health and cognition in first-episode schizophrenia patients and support the implementation of physical exercise interventions in this patient population to improve brain plasticity and cognitive functioning. (JINS, 2015, 21, 868-879).
    Full-text · Article · Nov 2015 · Journal of the International Neuropsychological Society
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    • "The average lifespan of individuals with schizophrenia is 20–25 years shorter than that of individuals without schizophrenia [1] [2] [3] [4] [5] [6]. Previous studies have revealed that comorbid cardiovascular disease (CVD) is the leading cause of death among patients with schizophrenia [7] [8]. "

    Preview · Article · Jan 2015
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    • "People with schizophrenia have a mortality risk two to three times greater than the general population. Specifically, there is an apparent increase in cardiovascular mortality relative to the general population (Brown et al., 2010). People with schizophrenia also have a higher prevalence of risk factors for cardiovascular diseases (CVD) such as diabetes, metabolic syndrome, and obesity compared with the general population (Casey, 2005; Huang et al., 2009). "
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    ABSTRACT: Second-generation antipsychotics (SGAs) have been associated with an increased liability for weight gain and metabolic side effects. Among SGAs, clozapine and olanzapine had great liability to induce weight gain and metabolic adverse reactions. Leptin, adiponectin, and total ghrelin play important roles in energy homeostasis and are suggested to be biomarkers of metabolic disturbances. The purpose of the present study was to investigate the differential effects of antipsychotics (olanzapine and clozapine) on the levels of adipocytokines (leptin and adiponectin) and total ghrelin. Three hundred and thirty-three patients with schizophrenia under clozapine or olanzapine monotherapy were recruited. Control participants were recruited from a healthy community population based on a health investigation (N=119). Fasting blood samples for glucose, cholesterol, triglycerides, leptin, adiponectin, and total ghrelin were analyzed. There were significant differences in the levels of cholesterol, triglycerides, and glucose between these three groups. Post hoc comparisons showed that the olanzapine group had the highest levels of cholesterol and triglycerides. The levels of leptin, adiponectin, and total ghrelin were also significantly different between the three groups after controlling age and body mass index (BMI). Post hoc comparisons showed that the olanzapine group had the lowest levels of adiponectin and total ghrelin. The present study found that the uses of olanzapine and clozapine were associated with changes in adipocytokines and total ghrelin, even after adjusting potential confounding factors. Olanzapine had greater influences on adiponectin and total ghrelin than clozapine. The changes in adipocytokines and total ghrelin were a direct effect of antipsychotics on hormonal pathways of energy homeostasis, rather than the result of weight gain. Copyright © 2014. Published by Elsevier Inc.
    Full-text · Article · Dec 2014 · Progress in Neuro-Psychopharmacology and Biological Psychiatry
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