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There is an excess of death from natural causes among people with
Schizophrenia and its treatment with neuroleptics were studied for their
prediction of mortality in a representative population sample of 7217
Finns aged ⩾30 years.
A comprehensive health examination was carried out at baseline.
Schizophrenia was determined using the Present State Examination and
previous medical records.
During a 17-year follow-up, 39 of the 99 people with schizophrenia died.
Adjusted for age and gender, the relative mortality risk between those
with schizophrenia and others was 2.84 (95% CI 2.06–3.90), and was2.25
(95%CI1.61–3.15) after further adjusting for somatic diseases, blood
pressure, cholesterol, body mass index, smoking, exercise, alcohol intake
and education. The number of neuroleptics used at the time of the
baseline survey showed a graded relation to mortality. Adjusted for age,
gender, somatic diseases and other potential risk factors for premature
death, the relative risk was 2.50 (95% CI1.46–4.30) per increment of one
There is an urgent need to ascertain whether the high mortality in
schizophrenia is attributable to the disorder itself or the antipsychotic
The impact of clinically diagnosed mental disorders on mortality in the general population has not been established.
To examine mental disorders for their prediction of cause-specific mortality.
Mental disorders were determined using the 36-item version of the General Health Questionnaire and the Present State Examination in a nationally representative sample of 8000 adult Finns.
During the 17-year follow-up period 1597 deaths occurred. The presence of a mental disorder detected at baseline was associated with an elevated mortality rate. The relative risk in men was 1.6 (95% confidence interval 1.3–1.8) and in women, 1.4 (95% Cl 1.2–1.6). In men and women with schizophrenia the relative risks of death during the follow-up period were 3.3 (95% Cl 2.3–4.9) and 2.3 (95% Cl 1.3–3.8) respectively, compared with the rest of the sample. In both men and women with schizophrenia the risk of dying of respiratory disease was increased, but the risk of dying of cardiovascular disease was increased only in men with neurotic depression.
Schizophrenia and depression are associated with an elevated risk of natural and unnatural deaths.
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