Adults with schizophrenia are 3.5 times more likely to die prematurely, particularly from cardiovascular and respiratory diseases, compared to the average population, according to a new study published online by JAMA Psychiatry.
Many factors contribute to the risk of premature death, including economic disadvantage, negative health behaviors, and difficulty accessing and adhering to medical treatments. Specifically, the following harmful traits are more common in those with schizophrenia than in the general population: smoking, limited physical activity, obesity, elevated blood glucose level, hypertension, and dyslipidemia (abnormal amount of lipids, such as fat or cholesterol, in the blood).
For the study, the researchers looked at a national group of more than 1.1 million Medicaid patients with schizophrenia (between the ages of 20 to 64) and 74,003 deaths, of which 65,553 had a known cause.
Among the 65,553 deaths with a known cause, 55,741 were from natural causes, which include a variety of diseases, and 9,812 were due to unnatural deaths, which included suicide, homicide assault, and accidents, both poisoning and non-poisoning, according to the results.
Cardiovascular disease had the highest mortality rate and accounted for almost one-third of all natural deaths. Cancer accounted for about one in six deaths. Among the other natural causes of death, chronic obstructive pulmonary disease (COPD), diabetes, influenza, and pneumonia had the highest mortality rates.
Unnatural causes of death accounted for about one in seven deaths with known causes, with suicide accounting for about one-quarter of the unnatural deaths. Accidents accounted for more than twice as many deaths as suicide.
Nonsuicidal substance-induced death, mostly from alcohol or other drugs, also was a leading cause of death.
Limitations noted by the authors include not having information about key health risk factors such as smoking status, body mass index, and substance abuse.
“The results from this study confirm a marked excess of deaths in schizophrenia, particularly from cardiovascular and respiratory disease, that is evident in early adulthood and persists into later life,” writes Mark Olfson, M.D., M.P.H., of Columbia University, New York, and coauthors.
“Especially high risks of mortality were observed from diseases for which tobacco use is a key risk factor. These findings support efforts to train mental health care professionals in tobacco use prevention and treatment and in implementation of policies that incentivize smoking control interventions in settings treating patients with schizophrenia.”