Abstract
BackgroundSuicide and death by accidents in persons with schizophrenia and bipolar disorder are common, but excess mortality from natural death accounts for even more years of life lost. The impact of somatic comorbidity, however, often is not duly considered in analyses and explanations of excess mortality in patients with psychotic disorders.Objective/MethodsThis study investigates and evaluates the impact of 19 severe chronic diseases on excess mortality due to diseases and medical conditions (natural death) in individuals with psychotic disorders compared with the general population using a population-based cohort study in Denmark. Incidence/mortality rate ratios of admission/mortality were calculated using survival analysis.ResultsCohort members with psychotic disorders had higher incidence rates of hospital contacts for almost all of the 19 disorders than the general population. The mortality rate ratio (MRR) of natural death was 7.10 (95% CI 6.45, 7.81) for schizophrenic men, decreasing to 4.64 (95% CI 4.21, 5.10) after adjustment for the somatic disorders. The same pattern existed in women and in both genders with bipolar disorder. Highest MRRs were observed for psychotic patients without hospital admissions with the investigated somatic disorders.ConclusionChronic somatic diseases accounted for half of the excess mortality in patients with schizophrenia or bipolar disorder. Chronic disorders investigated in this paper seem to be under-treated or under-detected among such patients.
Highlights
Premature death in persons with schizophrenia or bipolar disorder is well documented, both in descriptions dating back in history [1] and in recent studies [2,3,4,5,6]
The mortality rate ratio (MRR) of natural death was 7.10 for schizophrenic men, decreasing to 4.64 after adjustment for the somatic disorders
Chronic somatic diseases accounted for half of the excess mortality in patients with schizophrenia or bipolar disorder
Summary
Premature death in persons with schizophrenia or bipolar disorder is well documented, both in descriptions dating back in history [1] and in recent studies [2,3,4,5,6]. Excess mortality from diseases and medical conditions (death from natural causes) accounts for even more years of life lost in these patients than do suicide and death by accidents [7]. The impact of somatic comorbidity is often not duly considered in analyses and explanations of the excess mortality [14]. Suicide and death by accidents in persons with schizophrenia and bipolar disorder are common, but excess mortality from natural death accounts for even more years of life lost. The impact of somatic comorbidity, often is not duly considered in analyses and explanations of excess mortality in patients with psychotic disorders
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