Adults with schizophrenia in the United States die at approximately 3.5 times the rate of the general population, according to research published in JAMA Psychiatry.
Although suicide and other unnatural causes of death were higher than the general population, more than 85% of the deaths were natural, with the most common causes found to be cardiovascular and respiratory diseases.
These findings are important to communicate to clinicians so they can work with schizophrenic patients to prevent these common causes of death. “Accurate characterizations of premature mortality patterns are important to inform clinical and policy initiatives to improve services and reduce preventable deaths in the patient population,” wrote Mark Olfson, MD, MPH from the New York State Psychiatric Institute and the College of Physicians and Surgeons at Columbia University.
The researchers analyzed national Medicaid Analytic eXtract (MAX) data from the Centers for Medicare & Medicaid Services for over 1.1 million schizophrenic patients between the ages of 20 to 64 years old. They were followed until the loss of Medicaid eligibility, the date of death, or December 31, 2007, whichever occurred first. There were 74,003 deaths of which 65,553 had a known cause. Causes of death were determined from the National Death Index (NDI).
Causes of death were divided into natural causes (such as cardiovascular disease, cancer, diabetes, etc.), unnatural causes (such as suicide, accidents, assault (homicide), injuries, or drug-induced deaths), and nonsuicidal deaths from drugs or abuse. Deaths related to legal interventions such as encounters with law enforcement officials were also examined.
Cardiovascular disease had the highest mortality rate at approximately 1 out of 3 of all natural deaths. Cancer accounted for approximately 1 in 6 deaths. Among other natural causes of death, COPD, diabetes, and influenza and pneumonia had the highest mortality rates.
Unnatural causes of death accounted for approximately 1 out of 7 deaths, with poisoning and non-poisoning accounting for similar numbers of accidental deaths, and suicide accounting for 1 out of 4 of the unnatural causes of death. Substance abuse accounted for 8.2% of known-cause deaths and was usually non-suicidal.