Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

People with schizophrenia have increased natural mortality. There is much speculation but little evidence about the reasons behind this. This paper describes a study designed to measure the impact of pre-selected clinical, demographic and lifestyle variables on the natural mortality of a cohort with schizophrenia.

Methods

Ten-year Cox proportional hazards regression analysis of a community cohort of 95 people with schizophrenia.

Results

Death from natural causes was significantly associated with psychosis (HR 2.62, 95% CI 1.13–6.07), age (HR 1.08, 95% CI 1.02–1.13) and cigarette smoking (HR 2.53, 95% CI 1.01–6.34) at outset. There was a trend to association with low dietary unsaturated fat (P = 0.06).

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Rantanen H, Koivisto A-M, Salokangas R, Helminen M, Oja H, Pirkola S, Wahlbeck K, Joukamaa M (2009) Five-year mortality of Finnish schizophrenia patients in the era of deinstitutionalisation. Soc Psychiatry Psychiatr Epidemiol 44:135–142

    Article  PubMed  Google Scholar 

  2. Saha S, Chant D, McGrath J (2007) A systematic review of mortality in schizophrenia. Is the differential mortality gap worsening over time? Arch Gen Psychiatry 64:1123–1131

    Article  PubMed  Google Scholar 

  3. Kendler K (1986) A twin study of mortality in schizophrenia and neurosis. Arch Gen Psychiatry 43:643–649

    Article  PubMed  CAS  Google Scholar 

  4. Brown S, Kim M, Mitchell C, Inskip H (2010) Twenty five year mortality of a community cohort with schizophrenia. Br J Psychiatry 196:116–121

    Article  PubMed  Google Scholar 

  5. World Health Organisation (2009) Global health risks. Mortality and burden of disease attributable to selected major risks. WHO, Geneva

    Google Scholar 

  6. McEvoy J, Meyer J, Goff D, Nasrallah H, Davis S, Sullivan L, Meltzer H, Hsiao J, Stroup T, Lieberman J (2005) Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 80:19–32

    Article  PubMed  Google Scholar 

  7. Brown S, Birtwistle J, Roe L, Thomson C (1999) The unhealthy lifestyle of people with schizophrenia. Psychol Med 29:697–701

    Article  PubMed  CAS  Google Scholar 

  8. McCreadie R (2003) Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry 183:534–539

    Article  PubMed  CAS  Google Scholar 

  9. Okumura Y, Ito H, Kobayashi M, Mayahara K, Matsumoto Y, Hirakawa J (2010) Prevalence of diabetes and antipsychotic prescription patterns in patients with schizophrenia: a nationwide retrospective cohort study. Schizophr Res 119:145–152

    Article  PubMed  Google Scholar 

  10. Saarni S, Saarni S, Fogelholm M, Heliovaara M, Perälä J, Suvisaari J, Lönnqvist J (2009) Body composition in psychotic disorders: a general population survey. Psychol Med 39:801–811

    Article  PubMed  CAS  Google Scholar 

  11. Druss B, Bradford W, Rosenheck R, Radford M, Krumholz H (2001) Quality of medical care and excess mortality in older patients with mental disorders. Arch Gen Psychiatry 58:565–572

    Article  PubMed  CAS  Google Scholar 

  12. Tihonen J, Lönnquist J, Wahlbeck K, Laukka T, Niskanen L, Tanskanen A, Haukka J (2009) 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 374:620–627

    Article  Google Scholar 

  13. Henderson C, Thornicroft G, Glover G (1998) Inequalities in mental health. Br J Psychiatry 173:105–109

    Article  PubMed  CAS  Google Scholar 

  14. Kilbourne A, Morden N, Austin K, Ilgen M, McCarthy J, Dalack G, Blow F (2009) Excess heart-disease-related mortality in a national study of patients with mental disorders: identifying modifiable risk factors. Gen Hosp Psychiatry 31:555–563

    Article  PubMed  Google Scholar 

  15. Gibbons J, Horn S, Powell J, Gibbons J (1984) Schizophrenia patients and their families. A survey in a psychiatric service based on a DGH unit. Br J Psychiatry 144:70–77

    Article  PubMed  CAS  Google Scholar 

  16. World Health Organisation (1992) Schedules for clinical assessment in neuropsychiatry. WHO, Geneva

    Google Scholar 

  17. Roe L, Strong C, Whiteside C, Neil A, Mant D (1994) Dietary intervention in primary care: validity of the DINE method for diet assessment. Fam Pract 11:375–381

    Article  PubMed  CAS  Google Scholar 

  18. The Information Centre (2008) Health survey for England 2006. Cardiovascular disease and risk factors in adults. The Information Centre

  19. Godin G, Shephard R (1985) A simple method to assess exercise behaviour in the community. Can J Appl Sport Sci 10:141–146

    PubMed  CAS  Google Scholar 

  20. Bennett N, Dodd T, Flatley J, Freeth S, Bolling K (1995) Health survey for England 1993. HMSO, London

    Google Scholar 

  21. Walters S (2009) What is a Cox model? http://www.whatisseries.co.uk

  22. Working Group of the Royal College of Physicians, Psychiatrists and General Practitioners (1995) Alcohol and the heart in perspective. Sensible limits reaffirmed. J R Coll Phys Lond 29:266–271

    Google Scholar 

  23. SPSS (2009) SPSS for windows, version 17.0. Lead Technologies, Inc, Chicago

  24. Marder S, Essock S, Miller A, Buchanan R, Casey D et al (2004) Physical health monitoring in patients with schizophrenia. Am J Psychiatry 161:1334–1349

    Article  PubMed  Google Scholar 

  25. NICE (2009) Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. Nice clinical guideline 82. National Institute for Health and Clinical Excellence, London

  26. Brunner E, Stallone D, Juneja M, Bingham S, Marmot M (2001) Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. Br J Nutr 86:405–414

    Article  PubMed  CAS  Google Scholar 

  27. Fletcher G, Balady G, Blair S, Blumenthal J, Casperson C et al (1996) Statement on exercise: benefits and recommendations for physical activity programs for all Americans. Circulation 94:857–862

    PubMed  CAS  Google Scholar 

  28. Copeland L, Zeber J, Wang C-P, Parchamn M, Lawrence V, Valenstein M, Miller A (2009) Patterns of primary care and mortality among patients with schizophrenia or diabetes: a cluster analysis approach to the retrospective study of healthcare utilisation. BMC Health Serv Res 9:127

    Article  PubMed  Google Scholar 

  29. Tenorio-Martinez R, Lara-Munoz M, Medina-Mora E (2009) Measurement of problems in activities and participation in patients with anxiety, depression and schizophrenia using the ICF checklist. Soc Psychiatry Psychiatr Epidemiol 44:377–384

    Article  PubMed  Google Scholar 

  30. Gray R, Leese M, Bindman T, Becker L, Burti A, David K, Gournay K, Kikkert M, Koeter M, Puschner B (2006) Adherence therapy for people with schizophrenia: European multicentre randomised controlled trial. Br J Psychiatry 189:508–514

    Article  PubMed  Google Scholar 

  31. Gray R, Wykes T, Edmonds M, Leese M, Gournay K (2004) Effect of a medication management training package for nurses on clinical outcomes for patients with schizophrenia: cluster randomised controlled trial. Br J Psychiatry 185:57–162

    Article  Google Scholar 

  32. Velligan D, Diamond P, Mintz J, Maples N, Li X, Zeber J, Ereshefsky L, Lam Y-W, Castillo D, Miller A (2008) The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia. Schizophr Bull 34:483–493

    Article  PubMed  Google Scholar 

  33. Roberts L, Geppert C (2004) Ethical use of long-acting medications in the treatment of severe and persistent mental illness. Compr Psychiatry 45:161–167

    Article  PubMed  Google Scholar 

  34. Campion J, Checinski K, Nurse J (2008) Review of smoking cessation treatments for people with mental illness. Adv Psychiatr Treat 14:208–216

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Hampshire Partnership NHS Foundation Trust, Cannon House, 6 Cannon Street, Shirley, Southampton, SO15 5PQ, UK

    Steve Brown

  2. School of Medicine, University of Southampton, Southampton, UK

    Clemence Mitchell

Authors
  1. Steve Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Clemence Mitchell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steve Brown.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brown, S., Mitchell, C. Predictors of death from natural causes in schizophrenia: 10-year follow-up of a community cohort. Soc Psychiatry Psychiatr Epidemiol 47, 843–847 (2012). https://doi.org/10.1007/s00127-011-0392-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-011-0392-6

Keywords

Search

Navigation