P Kugathasan1,2, B Stubbs3,4, J Aagaard1,2, S E Jensen2,5, T Munk Laursen6, R E Nielsen1,2. 1. Psychiatry, Aalborg University Hospital, Aalborg, Denmark. 2. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 3. South London and Maudsley NHS Foundation Trust, London, UK. 4. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 5. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. 6. National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark.
Abstract
OBJECTIVE: To investigate the association of single- and multimorbidity with mortality rates in patients with schizophrenia compared to the general population. METHOD: A nationwide cohort study including residents in Denmark between 1995 and 2015. The cohort was dichotomously divided by a diagnosis of schizophrenia. Somatic diseases included infections, cancer, endocrine, neurologic, cardiovascular, respiratory, digestive, skin, musculoskeletal, and urogenital diseases. Hazard ratios (HRs) and population attributable fractions (PAFs) were calculated. RESULTS: The cohort included 30 210 patients with schizophrenia [mean age (SD) = 32.6 (11.4), males = 57.2%], and 5 402 611 from the general population [mean age (SD) = 33.0 (14.5), males = 50.4%]. All number of somatic diseases were associated with an increased mortality in schizophrenia [HR = 16.3 (95% CI = 15.4-17.3) for 1 disease to 21.0 (95% CI = 19.1-23.0) for ≥5 diseases], using the general population with no somatic disease as reference. Across all somatic diseases, patients with schizophrenia showed a HR > 2, compared to the general population, and respiratory (PAF = 9.3%), digestive (PAF = 8.2%), and cardiovascular (PAF = 7.9%) diseases showed largest contributions to death. CONCLUSIONS: Patients with schizophrenia showed higher mortality on all levels of multimorbidity, and a doubled mortality rate across all somatic diseases, compared to the general population. The findings suggest that the clusters and trajectories of symptoms associated with schizophrenia is the main driver of the excess mortality.
OBJECTIVE: To investigate the association of single- and multimorbidity with mortality rates in patients with schizophrenia compared to the general population. METHOD: A nationwide cohort study including residents in Denmark between 1995 and 2015. The cohort was dichotomously divided by a diagnosis of schizophrenia. Somatic diseases included infections, cancer, endocrine, neurologic, cardiovascular, respiratory, digestive, skin, musculoskeletal, and urogenital diseases. Hazard ratios (HRs) and population attributable fractions (PAFs) were calculated. RESULTS: The cohort included 30 210 patients with schizophrenia [mean age (SD) = 32.6 (11.4), males = 57.2%], and 5 402 611 from the general population [mean age (SD) = 33.0 (14.5), males = 50.4%]. All number of somatic diseases were associated with an increased mortality in schizophrenia [HR = 16.3 (95% CI = 15.4-17.3) for 1 disease to 21.0 (95% CI = 19.1-23.0) for ≥5 diseases], using the general population with no somatic disease as reference. Across all somatic diseases, patients with schizophrenia showed a HR > 2, compared to the general population, and respiratory (PAF = 9.3%), digestive (PAF = 8.2%), and cardiovascular (PAF = 7.9%) diseases showed largest contributions to death. CONCLUSIONS:Patients with schizophrenia showed higher mortality on all levels of multimorbidity, and a doubled mortality rate across all somatic diseases, compared to the general population. The findings suggest that the clusters and trajectories of symptoms associated with schizophrenia is the main driver of the excess mortality.
Authors: Nicholas Chak Lam Yung; Corine Sau Man Wong; Joe Kwun Nam Chan; Eric Yu Hai Chen; Wing Chung Chang Journal: Schizophr Bull Date: 2021-03-16 Impact factor: 9.306
Authors: Wing Chung Chang; Joe Kwun Nam Chan; Corine Sau Man Wong; JoJo Siu Han Hai; Philip Chi Fai Or; Eric Yu Hai Chen Journal: Schizophr Bull Date: 2020-07-08 Impact factor: 9.306
Authors: Gemma Biviá-Roig; Pau Soldevila-Matías; Gonzalo Haro; Victor González-Ayuso; Francisco Arnau; Loreto Peyró-Gregori; Laura García-Garcés; Maria I Sánchez-López; Juan Francisco Lisón Journal: Healthcare (Basel) Date: 2022-01-09