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11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).

https://arctichealth.org/en/permalink/ahliterature149701
Source
Lancet. 2009 Aug 22;374(9690):620-7
Publication Type
Article
Date
Aug-22-2009
Author
Jari Tiihonen
Jouko Lönnqvist
Kristian Wahlbeck
Timo Klaukka
Leo Niskanen
Antti Tanskanen
Jari Haukka
Author Affiliation
Department of Forensic Psychiatry, University of Kuopio and Niuvanniemi Hospital, Department of Clinical Physiology, Kuopio University Hospital, Kuopio, Finland. jari.tiihonen@niuva.fi
Source
Lancet. 2009 Aug 22;374(9690):620-7
Date
Aug-22-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Antipsychotic Agents - adverse effects
Case-Control Studies
Cause of Death
Clozapine - adverse effects
Dibenzothiazepines - adverse effects
Drug Utilization - trends
Female
Finland - epidemiology
Follow-Up Studies
Health Status Disparities
Humans
Life expectancy
Male
Middle Aged
Patient Readmission - statistics & numerical data
Perphenazine - adverse effects
Proportional Hazards Models
Registries
Risk factors
Schizophrenia - drug therapy - mortality
Sex Distribution
Time Factors
Abstract
The introduction of second-generation antipsychotic drugs during the 1990s is widely believed to have adversely affected mortality of patients with schizophrenia. Our aim was to establish the long-term contribution of antipsychotic drugs to mortality in such patients.
Nationwide registers in Finland were used to compare the cause-specific mortality in 66 881 patients versus the total population (5.2 million) between 1996, and 2006, and to link these data with the use of antipsychotic drugs. We measured the all-cause mortality of patients with schizophrenia in outpatient care during current and cumulative exposure to any antipsychotic drug versus no use of these drugs, and exposure to the six most frequently used antipsychotic drugs compared with perphenazine use.
Although the proportional use of second-generation antipsychotic drugs rose from 13% to 64% during follow-up, the gap in life expectancy between patients with schizophrenia and the general population did not widen between 1996 (25 years), and 2006 (22.5 years). Compared with current use of perphenazine, the highest risk for overall mortality was recorded for quetiapine (adjusted hazard ratio [HR] 1.41, 95% CI 1.09-1.82), and the lowest risk for clozapine (0.74, 0.60-0.91; p=0.0045 for the difference between clozapine vs perphenazine, and p
Notes
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897117
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897118
Comment In: Lancet. 2009 Aug 22;374(9690):590-219595448
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897121
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897120
PubMed ID
19595447 View in PubMed
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14-year outcome in early schizophrenia.

https://arctichealth.org/en/permalink/ahliterature248211
Source
Acta Psychiatr Scand. 1978 Oct;58(4):327-38
Publication Type
Article
Date
Oct-1978
Author
R C Bland
H. Orn
Source
Acta Psychiatr Scand. 1978 Oct;58(4):327-38
Date
Oct-1978
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Canada
Female
Fertility
Follow-Up Studies
Humans
Length of Stay
Male
Marriage
Prognosis
Schizophrenia - drug therapy - mortality
Sex Factors
Social Adjustment
Socioeconomic Factors
Abstract
Of 45 first admission schizophrenics from 1963, an incidence by first admission group for northern Alberta, 43 were followed-up 14 years later. Based on these figures the expectancy was found to be 0.49%. The proportion of patients who were married was less than expected in comparison with the general population, but amongst the married, fertility was probably comparable to the population's. At follow-up about half the patients were managing well with little or no disability, one quarter had moderate to marked disability and the remainder were socially, psychiatrically and occupationally disabled. From the time of first admission, patients had spent an average of 15% of their time in hospital and lost 28% of the total time due to psychiatric disability.
PubMed ID
717003 View in PubMed
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Antipsychotic polypharmacy and risk of death from natural causes in patients with schizophrenia: a population-based nested case-control study.

https://arctichealth.org/en/permalink/ahliterature98770
Source
J Clin Psychiatry. 2010 Feb;71(2):103-8
Publication Type
Article
Date
Feb-2010
Author
Lone Baandrup
Christiane Gasse
Vibeke D Jensen
Birte Y Glenthoj
Merete Nordentoft
Henrik Lublin
Anders Fink-Jensen
Anne Lindhardt
Preben B Mortensen
Author Affiliation
Centre for Neuropsychiatric Schizophrenia Research, Psychiatric Centre Glostrup, Copenhagen University Hospital, Glostrup, Nordre Ringvej 29-67, DK-2600 Glostrup, Denmark. lone.baandrup@cnsr.dk
Source
J Clin Psychiatry. 2010 Feb;71(2):103-8
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Antipsychotic Agents - administration & dosage - adverse effects
Benzodiazepines - adverse effects
Case-Control Studies
Cause of Death - trends
Denmark
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Odds Ratio
Risk factors
Schizophrenia - drug therapy - mortality
Abstract
OBJECTIVE: Concomitant prescription of more than 1 antipsychotic agent (antipsychotic polypharmacy) in the treatment of schizophrenia is prevalent, although monotherapy is generally recommended. Mortality from natural causes is markedly increased in schizophrenia, and the role of polypharmacy remains controversial. The objective was to investigate if antipsychotic polypharmacy is associated with the excess mortality from natural causes among patients with schizophrenia. METHOD: A population-based nested case-control study was conducted using patient data from January 1, 1996, to December 31, 2005, obtained from central Danish registers. From the study population of 27,633 patients with ICD-8- and ICD-10-diagnosed schizophrenia or other mainly nonaffective psychoses, aged 18-53 years, we identified 193 cases who died of natural causes within a 2-year period and 1,937 age- and sex-matched controls. Current drug use was defined as at least 1 prescription filled within 90 days before the date of death or the index date. The data were analyzed by conditional logistic regression. RESULTS: Risk of natural death did not increase with the number of concurrently used antipsychotic agents compared with antipsychotic monotherapy (no antipsychotics: adjusted odds ratio [OR] = 1.48 [95% CI, 0.89-2.46]; 2 antipsychotics: OR = 0.91 [95% CI, 0.61-1.36]; 3 or more antipsychotics: OR = 1.16 [95% CI, 0.68-2.00]). Current use of benzodiazepine derivatives with long elimination half-lives (more than 24 hours) was associated with increased risk of natural death in patients with schizophrenia treated with antipsychotics (OR = 1.78 [95% CI, 1.25-2.52]). CONCLUSIONS: Antipsychotic polypharmacy did not contribute to the excess mortality from natural causes in middle-aged patients with schizophrenia. The detected increased risk of death associated with benzodiazepines with long elimination half-lives calls for further clarification.
PubMed ID
19895781 View in PubMed
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Antipsychotic treatment and mortality in schizophrenia.

https://arctichealth.org/en/permalink/ahliterature269903
Source
Schizophr Bull. 2015 May;41(3):656-63
Publication Type
Article
Date
May-2015
Author
Minna Torniainen
Ellenor Mittendorfer-Rutz
Antti Tanskanen
Charlotte Björkenstam
Jaana Suvisaari
Kristina Alexanderson
Jari Tiihonen
Source
Schizophr Bull. 2015 May;41(3):656-63
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antipsychotic Agents - adverse effects - pharmacology
Cardiovascular Diseases - chemically induced - mortality
Cohort Studies
Female
Humans
Male
Middle Aged
Registries
Schizophrenia - drug therapy - mortality
Sweden - epidemiology
Young Adult
Abstract
It is generally believed that long-term use of antipsychotics increases mortality and, especially, the risk of cardiovascular death. However, there are no solid data to substantiate this view.
We identified all individuals in Sweden with schizophrenia diagnoses before year 2006 (N = 21 492), aged 17-65 years, and persons with first-episode schizophrenia during the follow-up 2006-2010 (N = 1230). Patient information was prospectively collected through nationwide registers. Total and cause-specific mortalities were calculated as a function of cumulative antipsychotic exposure from January 2006 to December 2010.
Compared with age- and gender-matched controls from the general population (N = 214920), the highest overall mortality was observed among patients with no antipsychotic exposure (hazard ratio [HR] = 6.3, 95% CI: 5.5-7.3), ie, 0.0 defined daily dose (DDD)/day, followed by high exposure (>1.5 DDD/day) group (HR = 5.7, 5.2-6.2), low exposure (
Notes
Cites: Acta Psychiatr Scand Suppl. 2000;401:3-3810887978
Cites: Am J Psychiatry. 2004 Aug;161(8):1334-4915285957
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Cites: Pharmacogenomics. 2009 Sep;10(9):1511-2619761372
Cites: Am J Psychiatry. 2010 Feb;167(2):151-920008945
Cites: J Clin Psychiatry. 2010 Feb;71(2):103-819895781
Cites: Am J Psychiatry. 2011 Jun;168(6):603-921362741
Cites: Am J Psychiatry. 2013 Mar;170(3):324-3323318474
Cites: Schizophr Bull. 2013 May;39(3):648-5722282455
Cites: PLoS One. 2013;8(6):e6713323826212
Cites: Schizophr Res. 2014 Jan;152(1):246-5424275583
PubMed ID
25422511 View in PubMed
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Do antipsychotic medications reduce or increase mortality in schizophrenia? A critical appraisal of the FIN-11 study.

https://arctichealth.org/en/permalink/ahliterature146184
Source
Schizophr Res. 2010 Mar;117(1):68-74
Publication Type
Article
Date
Mar-2010
Author
Marc De Hert
Christoph U Correll
Dan Cohen
Author Affiliation
University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Belgium. marc.de.hert@uc-kortenberg.be
Source
Schizophr Res. 2010 Mar;117(1):68-74
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Clozapine - therapeutic use
Dibenzothiazepines - therapeutic use
Female
Finland - epidemiology
Haloperidol - therapeutic use
Humans
Male
Perphenazine - therapeutic use
Risperidone - therapeutic use
Schizophrenia - drug therapy - mortality
Suicide - statistics & numerical data
Survival Rate
Abstract
Compared to the general population, people with schizophrenia are at risk of dying prematurely due to suicide and due to different somatic illnesses. The potential role of antipsychotic treatment in affecting suicide rates and in explaining the increased mortality due to somatic disorders is highly debated. A recent study of death registers in Finland compared the cause-specific mortality in 66,881 patients versus the total population (5.2 million) between 1996 and 2006, suggesting that antipsychotic use decreased all-cause mortality compared to no antipsychotic use in patients with schizophrenia, and that clozapine had the most beneficial profile in this regard (Tiihonen et al., 2009). The benefits of clozapine were conferred by significant protective effects for suicide compared to perphenazine, whereas, a mixed group of 'other' antipsychotics, haloperidol, quetiapine and risperidone were reported to be associated with significantly higher all-cause mortality than perphenazine. By contrast, despite known differences in effects on cardiovascular risk factors, there were no significant differences between any of the examined antipsychotics regarding death due to ischemic heart disease. A number of methodological and conceptual issues make the interpretation of these findings problematic, including incomplete reporting of data, questionable selection of drug groups and comparisons, important unmeasured risk factors, inadequate control for potentially confounding variables, exclusion of deaths occurring during hospitalization leading to exclusion of 64% of deaths on current antipsychotics from the analysis, and survivorship bias due to strong and systematic differences in illness duration across the treatment groups. Well designed, prospective mortality studies, with direct measurement of and adjustment for all known relevant risk factors for premature mortality, are needed to identify risk and protective medication and patient factors and to, ultimately, inform clinical practice.
PubMed ID
20060684 View in PubMed
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Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study.

https://arctichealth.org/en/permalink/ahliterature168429
Source
BMJ. 2006 Jul 29;333(7561):224
Publication Type
Article
Date
Jul-29-2006
Author
Jari Tiihonen
Kristian Wahlbeck
Jouko Lönnqvist
Timo Klaukka
John P A Ioannidis
Jan Volavka
Jari Haukka
Author Affiliation
Department of Forensic Psychiatry, University of Kuopio, Niuvanniemi Hospital, FIN-70240 Kuopio, Finland. jari.tiihonen@niuva.fi
Source
BMJ. 2006 Jul 29;333(7561):224
Date
Jul-29-2006
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Cohort Studies
Community Mental Health Services - statistics & numerical data
Female
Finland - epidemiology
Humans
Length of Stay
Male
Patient Readmission - statistics & numerical data
Prospective Studies
Psychotic Disorders - drug therapy - mortality
Risk factors
Schizophrenia - drug therapy - mortality
Treatment Outcome
Treatment Refusal
Abstract
To study the association between prescribed antipsychotic drugs and outcome in schizophrenia or schizoaffective disorder in the community.
Prospective cohort study using national central registers.
Community care in Finland.
Nationwide cohort of 2230 consecutive adults hospitalised in Finland for the first time because of schizophrenia or schizoaffective disorder, January 1995 to December 2001.
Rates of discontinuation of drugs (all causes), rates of rehospitalisation, and mortality associated with monotherapy with the 10 most commonly used antipsychotic drugs. Multivariate models and propensity score methods were used to adjust estimates of effectiveness.
Initial use of clozapine (adjusted relative risk 0.17, 95% confidence interval 0.10 to 0.29), perphenazine depot (0.24, 0.13 to 0.47), and olanzapine (0.35, 0.18 to 0.71) were associated with the lowest rates of discontinuation for any reason when compared with oral haloperidol. During an average follow-up of 3.6 years, 4640 cases of rehospitalisation were recorded. Current use of perphenazine depot (0.32, 0.22 to 0.49), olanzapine (0.54, 0.41 to 0.71), and clozapine (0.64, 0.48 to 0.85) were associated with the lowest risk of rehospitalisation. Use of haloperidol was associated with a poor outcome among women. Mortality was markedly raised in patients not taking antipsychotics (12.3, 6.0 to 24.1) and the risk of suicide was high (37.4, 5.1 to 276).
The effectiveness of first and second generation antipsychotics varies greatly in the community. Patients treated with perphenazine depot, clozapine, or olanzapine have a substantially lower risk of rehospitalisation or discontinuation (for any reason) of their initial treatment than do patients treated with haloperidol. Excess mortality is seen mostly in patients not using antipsychotic drugs.
Notes
Cites: N Engl J Med. 2000 Jun 22;342(25):1887-9210861325
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Cites: BMJ. 2001 Apr 14;322(7291):879-8011302887
Cites: JAMA. 2001 Aug 15;286(7):821-3011497536
Cites: J Clin Epidemiol. 2001 Nov;54(11):1181-611675171
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Cites: Ann Intern Med. 1997 Oct 15;127(8 Pt 2):757-639382394
Cites: BMJ. 1998 Oct 31;317(7167):1181-49794850
Cites: Arch Gen Psychiatry. 1999 Aug;56(8):733-4010435608
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Cites: BMJ. 2000 Dec 2;321(7273):1371-611099280
Comment In: BMJ. 2006 Jul 29;333(7561):212-316873834
Comment In: BMJ. 2006 Aug 12;333(7563):35316902223
PubMed ID
16825203 View in PubMed
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The effect of long-term treatment with clozapine in schizophrenia: a retrospective study in 96 patients treated with clozapine for up to 13 years.

https://arctichealth.org/en/permalink/ahliterature233085
Source
Acta Psychiatr Scand. 1988 May;77(5):524-9
Publication Type
Article
Date
May-1988
Author
L H Lindström
Author Affiliation
Psychiatric Research Center, University of Uppsala, Sweden.
Source
Acta Psychiatr Scand. 1988 May;77(5):524-9
Date
May-1988
Language
English
Publication Type
Article
Keywords
Adult
Clozapine - adverse effects - therapeutic use
Dibenzazepines - therapeutic use
Employment
Female
Humans
Leukopenia - chemically induced
Male
Psychotic Disorders - drug therapy
Retrospective Studies
Schizophrenia - drug therapy - mortality
Sweden
Abstract
A retrospective study was performed to evaluate the effect of long-term treatment with clozapine in 96 schizophrenic or schizoaffective patients hospitalized at the Psychiatric Research Center in Uppsala during the period 1974-1986. All patients had previously been treated with different neuroleptics but with inadequate response or distressing side effects. The mean duration of the disorder at the start of clozapine treatment was 8 years and 9 months and the mean duration of the treatment 3 years and 11 months. Clozapine treatment was discontinued in 36% of the patients, mainly due to lack of efficacy, poor compliance or temporary withdrawal of the drug from the market in 1975. In two patients the reason was leukopenia or agranulocytosis. In another 10 patients a transient decrement of WBC was seen, which was normalized during ongoing treatment. Four patients died when on clozapine during the follow-up period, but no causal relationship to the treatment could be established. Eighty-five per cent of the patients could be discharged from the hospital. Of the 62 patients who were still on clozapine after 2 years, 18% had full time and 21% half-time employment. A global evaluation of the clinical efficacy revealed a significant improvement in 43% and a moderate improvement in 38% of the patients compared to previous neuroleptic treatments. Common but usually mild side effects were sedation, hypersalivation, weight gain, and obstipation. Four patients had grand mal seizures. No extrapyramidal side effects were observed during clozapine treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
3407421 View in PubMed
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Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care.

https://arctichealth.org/en/permalink/ahliterature186188
Source
Eur Psychiatry. 2003 Feb;18(1):1-5
Publication Type
Article
Date
Feb-2003
Author
O. Kampman
A. Illi
P. Poutanen
E. Leinonen
Author Affiliation
University of Tampere, Medical School and Tampere Community Mental Health Care, 33014, Finland. olli.kampman@uta.fi
Source
Eur Psychiatry. 2003 Feb;18(1):1-5
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Deinstitutionalization
Female
Finland - epidemiology
Home Care Services
Hospitalization - statistics & numerical data
Humans
Male
Outpatients
Patient compliance
Recurrence - prevention & control
Retrospective Studies
Schizophrenia - drug therapy - mortality - rehabilitation
Schizophrenic Psychology
Treatment Outcome
Abstract
Non-compliance in neuroleptic maintenance treatment is a major concern in schizophrenia. Home-based outpatient care has been shown both to improve medication compliance and reduce relapse frequency. We analysed the need for hospitalisation, levels of functioning and mortality rate during the de-institutionalisation process in 41 schizophrenia patients with repeated hospitalisations and prolonged history of non-compliance. Eighteen of the patients received ambulatory outpatient care (AOC) after discharge. This treatment procedure focuses on enduring neuroleptic maintenance treatment. One of the hospital nurses takes care of home visits every 2-4 weeks. In the 4-year follow-up, half of the patients in the AOC group did not need hospitalisation at all and the number of days of hospitalisation in the whole group diminished by almost four-fifths compared with the previous 4 years. In the non-AOC group, there was a more limited decrease in the number of days of hospitalisation during the corresponding follow-up period. The mortality rates showed a slight tendency towards a better outcome in the AOC group. There was no change in the levels of functioning in the AOC group. This treatment can be carried out with limited resources. It clearly reduces the need for hospitalisation in a subgroup of schizophrenia patients having problems with compliance and recurrent relapse. The effectiveness of AOC on the mortality rates of schizophrenia patients needs further examination.
PubMed ID
12648888 View in PubMed
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Mortality and Cumulative Exposure to Antipsychotics, Antidepressants, and Benzodiazepines in Patients With Schizophrenia: An Observational Follow-Up Study.

https://arctichealth.org/en/permalink/ahliterature282358
Source
Am J Psychiatry. 2016 Jun 01;173(6):600-6
Publication Type
Article
Date
Jun-01-2016
Author
Jari Tiihonen
Ellenor Mittendorfer-Rutz
Minna Torniainen
Kristina Alexanderson
Antti Tanskanen
Source
Am J Psychiatry. 2016 Jun 01;173(6):600-6
Date
Jun-01-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antidepressive Agents - administration & dosage - adverse effects - therapeutic use
Antipsychotic Agents - administration & dosage - adverse effects - therapeutic use
Benzodiazepines - administration & dosage - adverse effects - therapeutic use
Databases, Factual
Drug Utilization - statistics & numerical data
Female
Humans
Male
Middle Aged
Proportional Hazards Models
Risk factors
Schizophrenia - drug therapy - mortality
Sweden
Young Adult
Abstract
Although mortality related to psychotropic medications has received much attention in recent years, little is known about the relationship between risk of death and cumulative antipsychotic load, and even less about the relationship between mortality and cumulative exposure to antidepressants or benzodiazepines. The authors examined these relationships using nationwide databases.
The authors used prospectively collected nationwide databases to identify all individuals 16-65 years of age with a schizophrenia diagnosis (N=21,492) in Sweden. All-cause and cause-specific mortality rates were calculated as a function of cumulative low, moderate, and high exposure to antipsychotics, antidepressants, and benzodiazepines from 2006 through 2010.
Compared with no exposure, both moderate (adjusted hazard ratio=0.59, 95% CI=0.49-0.70) and high (adjusted hazard ratio=0.75, 95% CI=0.63-0.89) antipsychotic exposures were associated with substantially lower overall mortality. Moderate antidepressant exposure was associated with a lower mortality (adjusted hazard ratio=0.85, 95% CI=0.73-0.98), and high exposure, even lower (adjusted hazard ratio=0.71, 95% CI=0.59-0.86). Exposure to benzodiazepines showed a dose-response relationship with mortality (hazard ratios up to 1.74 [95% CI=1.50-2.03]).
Moderate and high-dose antipsychotic and antidepressant use were associated with 15%-40% lower overall mortality, whereas chronic high-dose use of benzodiazepines was associated with up to a 70% higher risk of death compared with no exposure. Since patients with anxiety and depressive symptoms may have a higher intrinsic risk of death, the finding for benzodiazepines may be attributable to some extent to residual confounding.
PubMed ID
26651392 View in PubMed
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Mortality and its determinants in people with psychotic disorder.

https://arctichealth.org/en/permalink/ahliterature117876
Source
Psychosom Med. 2013 Jan;75(1):60-7
Publication Type
Article
Date
Jan-2013
Author
Jaana Suvisaari
Krista Partti
Jonna Perälä
Satu Viertiö
Suoma E Saarni
Jouko Lönnqvist
Samuli I Saarni
Tommi Härkänen
Author Affiliation
Department of Mental Health and Substance Abuse Services, National Institute forHealth and Welfare, Helsinki, Finland. jaana.suvisaari@thl.fi
Source
Psychosom Med. 2013 Jan;75(1):60-7
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adult
Affective Disorders, Psychotic - drug therapy - mortality
Antipsychotic Agents - therapeutic use
Cohort Studies
Diabetes Mellitus, Type 2 - mortality
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Humans
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Psychotic Disorders - drug therapy - mortality
Risk factors
Schizophrenia - drug therapy - mortality
Smoking - mortality
Abstract
We investigated mortality and its determinants in people with psychotic disorder.
A nationally representative two-stage cluster sample of 8028 persons aged 30 years or older from Finland was selected for a comprehensive health survey conducted from 2000 to 2001. Participants were screened for psychotic disorder, and screen-positive persons were invited for a Structured Clinical Interview for DSM-IV. The diagnostic assessment of DSM-IV psychotic disorders was based on the Structured Clinical Interview for DSM-IV, case records from mental health treatments, or both. Mortality was followed up until September 2009 and analyzed using Cox proportional hazards model.
People with schizophrenia (hazard ratio [HR] = 3.03; 95% confidence interval [CI] = 1.93-4.77) and other nonaffective psychoses (HR = 1.84; 95% CI = 1.17-2.91) had elevated mortality risk, whereas people with affective psychoses did not (HR = 0.61; 95% CI = 0.24-1.55). Antipsychotic medication use was associated with increased mortality (HR = 2.34; 95% CI = 1.86-2.96). There was an interaction between antipsychotic medication use and the presence of a psychotic disorder: antipsychotic medication use was only associated with elevated mortality in persons who were using antipsychotics and did not have primary psychotic disorder. In persons with psychotic disorder, mortality was predicted by smoking and Type 2 diabetes at baseline survey.
Schizophrenia and nonaffective psychoses are associated with increased mortality risk, whereas affective psychoses are not. Antipsychotic medication use increases mortality risk in older people without primary psychotic disorder, but not in individuals with schizophrenia. Smoking and Type 2 diabetes are important predictors of elevated mortality risk in persons with psychotic disorder.
PubMed ID
23257931 View in PubMed
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12 records – page 1 of 2.