New research discovers that individuals with schizophrenia are not benefiting from public health and health care interventions to the same degree as individuals without schizophrenia.
In the study, Canadian researchers found that people with schizophrenia have a mortality rate that is three times greater each year than those without schizophrenia, and die on average, eight years earlier than people without schizophrenia.
The research appears in the Canadian Medical Association Journal.
“As health care providers, it is our responsibility to work together across our health care system to provide these patients with better, integrated physical and mental health care. By not doing so, there are dire, tragic consequences and shortened lives,” said Dr. Paul Kurdyak, a researcher at the Centre for Addiction and Mental Health (CAMH) and the Institute for Clinical Evaluative Sciences (ICES).
Researchers studied all deaths during the 20-year period between 1993 and 2012 in Ontario and examined the deaths annually. They identified all people with schizophrenia and categorized the deaths as occurring among those with and without schizophrenia.
The study showed that individuals with schizophrenia had higher rates of death for all causes including cardiovascular diseases and chronic medical conditions.
Cardiovascular disease, such as heart attack or stroke, is a leading cause of death in the general population. However, while the rest of Ontario has experienced a reduction in cardiovascular deaths, the study shows that individuals with schizophrenia are not experiencing the same reduction.
People with schizophrenia have many cardiovascular risk factors such as diabetes, obesity, smoking, and sedentary lifestyle, but are more burdened by these risk factors than those without schizophrenia.
Medications used to treat schizophrenia can cause weight gain and the development of diabetes.
“It seems that people with schizophrenia haven’t benefited from the advances that we have made for patients living with chronic physical illnesses in the general population,” says Dr. Kurdyak.
“A health care system that can address the mortality gap we have observed in this study would truly be a high performing health care system.”
The complex needs of individuals with schizophrenia and comorbid medical conditions create a tremendous challenge to providers and health care systems more broadly,” explains Kurdyak.
“Although there have been numerous calls to action to help individuals with severe mental illness, such as schizophrenia, to manage chronic medical illnesses, and although the declining trends and narrowing absolute gap that we observed are positive developments, more effort is required to reduce the considerable disparity in both mortality and illness burden,” the study concludes.
“A gap in life expectancy of this size for any other group of patients might reasonably be expected to lead to correspondingly substantial public health action to redress the health inequality,” writes Dr. Philip Ward, University of New South Wales Sydney, Sydney, Australia, in a related commentary.
“However, this does not appear to be the case for people with schizophrenia.”
He suggests that strategies to reduce smoking, diet and exercise interventions to counteract weight gain experienced from drugs to control schizophrenia and managing chronic disease can help narrow the life expectancy gap.