Mortality in people with schizophrenia

By Scott Cunningham, MD, PhD
Published June 22, 2022

Key Takeaways

  • Patients with schizophrenia have higher all-cause mortality, suicide, and natural cause risk ratios (RRs) than the general population without schizophrenia.

Putting It Into Practice

Awareness of the causes of premature mortality among patients with schizophrenia facilitates the implementation of preventive strategies and comprehensive healthcare, such as smoking cessation, cardiovascular screening, promoting physical activity, and use of antipsychotics.

Why this study matters

Longevity among patients with schizophrenia is reduced 15-20 years compared to the general population without schizophrenia. The physical conditions and lifestyle behaviors that contribute to premature mortality have been identified, and the benefit of antipsychotics has been established.

Study design

The data from 135 studies conducted between 1957 and 2021 were analyzed. A total of 4,536,447 patients diagnosed with schizophrenia and 1,115,600,059 individuals from the general population without schizophrenia were included in the analysis.

Results and conclusion

The all-cause mortality RR was higher in schizophrenics than the general population (RR=2.52). The mortality RRs for suicide and natural causes were also higher in schizophrenics than the general population, as follows: suicide, injury-poisoning, undetermined non-natural causes (RR=9.76); pneumonia (RR=7.0); infectious diseases, endocrine, respiratory, and urogenital (RR=3-4); alcohol, gastrointestinal, renal, neurologic, cardiac, and cerebrovascular (RR=2-3); and liver, cerebrovascular, and breast, colon, and pancreatic cancers (RR=1.33-1.96).

All-cause mortality and suicides RRs were higher in schizophrenics < 40 years of age than non-schizophrenics > 40 years of age. Schizophrenics with a co-morbid substance abuse disorder had a higher all-cause mortality RR than schizophrenics without a co-morbid substance abuse disorder. Anti-psychotic use in schizophrenics was associated with a lower all-cause mortality RR than schizophrenics not taking anti-psychotics.

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