Excess deaths from cardiovascular and respiratory diseases in individuals with schizophrenia are due to modifiable cardiovascular risk factors, especially tobacco use, according to a retrospective longitudinal study of a cohort of more than 1 million adults with schizophrenia.
Participants, all Medicaid patients, ranged in age from 20 to 64 years. The cohort included 1.139 million individuals, 4.8 million years of follow-up, and 65,553 deaths from a known cause.
Compared to the general population, individuals with schizophrenia were more than 3.5 times as likely to die. Additionally:
• Cardiovascular disease had the highest mortality rate: 403.2 per 100,000 person-years.
• Lung cancer had the highest cancer mortality rate: 74.8 per 100,000 person-years.
• Accidental deaths occurred at a rate of 119.7 per 100,000 person-years, compared with suicide, at 52.0 per 100,000 person-years.
• Nonsuicidal substance-induced death, mostly from alcohol or other drugs, occurred at a rate of 95.2 per 100,000 person-years.
Citation: Olfson M, Gerhard T, et al. Premature mortality among adults with schizophrenia in the United States. [Published online ahead of print October 28, 2015]. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2015.1737.