Abstract

ObjectiveExcess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause specific Standardized Mortality Rates (SMRs) were calculated for each specific subgroup of mortality. Life expectancy was calculated using Wiesler’s method.ResultsThe SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes. SMR was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark. Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter.ConclusionOur data show that persons in the Nordic countries with schizophrenia or bipolar disorder have a substantially reduced life expectancy. An evaluation of the reasons for these increased mortality rates should be prioritized when planning healthcare in the coming years.

Highlights

  • Excess mortality from diseases and medical conditions in persons with psychiatric disorders has been extensively reported [1]

  • Standardized Mortality Rates (SMRs) was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark

  • Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter

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Summary

Introduction

Excess mortality from diseases and medical conditions in persons with psychiatric disorders has been extensively reported [1]. In the Nordic countries, women and men with severe mental disorders have an approximately 15 and 20 years shorter life expectancy, respectively, than the general population [8]. Cardiac mortality has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease [11]. A study from Denmark showed that patients with bipolar affective disorder or schizophrenia still have an overall cardiac mortality that is higher than in the general population, and that the excess mortality tends to be even larger in the most recent calendar time period [12]

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