Increasing Mortality Gap Associated with Schizophrenia
> 11/2/2007 12:27:44 PM

Scientists have long known that individuals with schizophrenia often die at an earlier age than people without schizophrenia. A new study published in the October issue of Archives of General Psychology explores the increasing mortality gap between those with schizophrenia and those without the disorder. Unfortunately, the study indicates that despite an increased awareness of the important role mental health plays in overall health, the number of early deaths associated with schizophrenia has risen over the past few decades.

The researchers studied data from 37 previous studies on the mortality rates in people with schizophrenia. The 37 studies were published between 1980 and 2006 and represented 25 different countries. The researchers then calculated standard mortality ratios (SMR) by dividing the sum of observed deaths by the sum of expected deaths (the number of deaths that could be expected based on age and sex within the general population). With this information, they were able to look at the SMRs associated with gender, specific causes of death, and the economic development of the countries where the studies occurred.

The median SMR for all causes of death was 2.5, meaning that people with schizophrenia have a 2.5 greater chance of dying than the rest of the general population. When looking at individual causes of death, the median SMR was highest, at 12.8, for suicide. Next was infectious diseases, with a median SMR of 4.29, followed closely by nervous diseases, which had a SMR of 4.22. In terms of gender, the researchers did not find a significant difference between the SMRs of men and women with schizophrenia. When looking at country of origin, the SRMs were highest in developed nations, where the median SMR was 2.7. In emerging countries, the median SMR was 2.1, and the least developed nations had a median SMR of 2.0. However, the researchers also stress that only three studies contributed to this finding. More data is necessary to truly determine whether or not a significant difference exists between the mortality rates for those with schizophrenia within developing and developed nations.

The study shows that the median SRM has increased over time, rising from 1.8 in the 1970s to 2.9 in the 1980s and 3.2 in the 1990s, and there are many barriers to treatment for those with schizophrenia which may explain why the mortality gap has continued to grow. Individuals with schizophrenia may be unable to find available mental health services or they may be unwilling to get help due to the social stigmas of mental illness. The researchers speculate that those diagnosed with schizophrenia are less likely to seek health care, less likely to comply with treatments, and more likely to engage in risky behaviors which can threaten their health.

The researchers also implicate medication as an important factor in the mortality gap. Scientists originally believed second-generation, or atypical, antipsychotics, which were introduced in the early 1990s, would increase the quality of life of people with schizophrenia. However, researchers now worry about adverse side effects, including weight gain and metabolic syndrome. Those with metabolic syndrome are 2 to 3 times more likely to die from cardiovascular disease and 2 times more likely to die for any reason.

Over the past few decades, scientists have discovered new ways to improve physical and mental health, but those with schizophrenia have not felt the same benefits as the rest of the population. We must be aware of the potential health problems facing those with schizophrenia. Knowing that schizophrenia continues to be associated with early deaths, we must research ways to better the physical and mental health of those who suffer from it.

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