Maria Fagerbakke Strømme1, Liv Solrunn Mellesdal2, Christoffer Bartz-Johannesen3, Rune Andreas Kroken4, Marianne Krogenes5, Lars Mehlum6, Erik Johnsen7. 1. Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway. Electronic address: maria.stromme@helse-bergen.no. 2. Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway. Electronic address: liv.solrunn.mellesdal@helse-bergen.no. 3. Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway. Electronic address: christoffer.andreas.bartz-johannessen@helse-bergen.no. 4. Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway. Electronic address: rune.andreas.kroken@helse-bergen.no. 5. Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway. Electronic address: marianne.leiknes.krogenes@helse-bergen.no. 6. National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Sognsvannsveien 21, Bygg 12, 0372 Oslo, Norway. Electronic address: lars.mehlum@medisin.uio.no. 7. Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway. Electronic address: erik.johnsen@helse-bergen.no.
Abstract
BACKGROUND: In society at large, it is debated whether use of antipsychotic drugs is associated with increased or decreased mortality among patients with schizophrenia. Large register studies have demonstrated an increased mortality risk associated with non-use of antipsychotic drugs, but prospective studies are missing. AIMS: To investigate the association between mortality and non-use of antipsychotics in patients with schizophrenia. METHOD: An open cohort study included and followed all patients with a discharge-diagnosis of schizophrenia consecutively admitted to a psychiatric acute unit at Haukeland University Hospital, Bergen, Norway during a 10 year period (n = 696). Cox multiple regression analyses were conducted with use of antipsychotic drugs as a time dependent variable, and periods of use and non-use were compared within individual patients. Adjustments were made for gender, age at index admission, number of acute psychiatric hospital admissions, excessive use of alcohol and illicit substances and use of benzodiazepines and antidepressants. RESULTS: A total of 68 (9.8%) deaths were registered during follow-up. Of these, 40 (59%) had natural causes, whereas 26 (38%) had unnatural causes. Non-use of antipsychotics was associated with 2.15 (p = .01, CI: 1.24-3.72) times higher mortality risk compared to use of antipsychotics. The difference in mortality risk between use and non-use of antipsychotic drugs was age dependent, with the largest risk difference in young patients. CONCLUSIONS: Non-use of antipsychotic drugs was associated with twofold increased mortality risk in patients with schizophrenia.
BACKGROUND: In society at large, it is debated whether use of antipsychotic drugs is associated with increased or decreased mortality among patients with schizophrenia. Large register studies have demonstrated an increased mortality risk associated with non-use of antipsychotic drugs, but prospective studies are missing. AIMS: To investigate the association between mortality and non-use of antipsychotics in patients with schizophrenia. METHOD: An open cohort study included and followed all patients with a discharge-diagnosis of schizophrenia consecutively admitted to a psychiatric acute unit at Haukeland University Hospital, Bergen, Norway during a 10 year period (n = 696). Cox multiple regression analyses were conducted with use of antipsychotic drugs as a time dependent variable, and periods of use and non-use were compared within individual patients. Adjustments were made for gender, age at index admission, number of acute psychiatric hospital admissions, excessive use of alcohol and illicit substances and use of benzodiazepines and antidepressants. RESULTS: A total of 68 (9.8%) deaths were registered during follow-up. Of these, 40 (59%) had natural causes, whereas 26 (38%) had unnatural causes. Non-use of antipsychotics was associated with 2.15 (p = .01, CI: 1.24-3.72) times higher mortality risk compared to use of antipsychotics. The difference in mortality risk between use and non-use of antipsychotic drugs was age dependent, with the largest risk difference in young patients. CONCLUSIONS: Non-use of antipsychotic drugs was associated with twofold increased mortality risk in patients with schizophrenia.
Authors: Maria F Strømme; Liv S Mellesdal; Christoffer A Bartz-Johannesen; Rune A Kroken; Marianne L Krogenes; Lars Mehlum; Erik Johnsen Journal: J Clin Psychopharmacol Date: 2022 Jan-Feb 01 Impact factor: 3.153
Authors: Christine Henriksen Oedegaard; Ana Lorena Ruano; Anne Blindheim; Marius Veseth; Brynjulf Stige; Larry Davidson; Ingunn Marie Stadskleiv Engebretsen Journal: Int J Ment Health Syst Date: 2022-04-04