Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort
Year: 2014
Type: article
Study design: Observational Study
Abstract: The excess mortality in people with psychotic disorders is a major public health concern, but little is known about the clinical and social risk factors which may predict this health inequality and help inform preventative strategies. We aimed to investigate mortality in a large epidemiologically characterized cohort of individuals with first-episode psychosis compared with the general population and to determine clinical and social risk factors for premature death. All 557 individuals with first-episode psychosis initially identified in 2 areas (Southeast London and Nottinghamshire, United Kingdom) were traced over a 10-year period in the ӔSOP-10 study. Compared with the general population, all-cause (standardized mortality ratio [SMR] 3.6, 95% confidence interval [CI] 2.6-4.9), natural-cause (SMR 1.7, 95% CI 1.0-2.7) and unnatural-cause (SMR 13.3, 95% CI 8.7-20.4) mortality was very high. Illicit drug use was associated with an increased risk of all-cause mortality (adj. rate ratio [RR] 2.31, 95% CI 1.06-5.03). Risk of natural-cause mortality increased with a longer time to first remission (adj. RR 6.61, 95% CI 1.33-32.77). Family involvement at first contact strongly reduced risk of unnatural-cause mortality (adj. RR 0.09, 95% CI 0.01-0.69). Our findings suggest that the mortality gap in people with psychotic disorders remains huge and may be wider for unnatural-cause mortality than previously reported. Efforts should now focus on further understanding and targeting these tractable clinical and social risk factors of excess mortality. Early intervention and dual diagnosis services may play a key role in achieving more rapid remission and carer involvement and addressing substance use problems to reduce excess mortality in psychosis.
Source: Schizophrenia Bulletin
Institutions: King's College London, University of Cambridge, National Institute for Health and Care Research, NIHR Cambridge Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, University of Nottingham, Trinity College Dublin, UNSW Sydney, University College London, University of York
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,495
Funders: Eli Lilly and Company, South London and Maudsley NHS Foundation Trust, Wellcome Trust, National Institute for Health and Care Research, Royal Society, Academy of Medical Sciences, King's College London, European Commission, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Medical Research Council
Awards: G1319386418, Psychosis risk over the life course: A multilevel, longitudinal investigation of social, economic and physical environmental risk factors at different stages in life., G1998218567, Understanding Causes and Developing Effective Interventions For Schizophrenia and Other Psychoses, The Cambridge-UCL Mental Health and Neurosciences Network., G3858511603, G427493043, G457166169, G5234178300, G5307689689, Psychosis risk over the life course: A multilevel, longitudinal investigation of social, economic and physical environmental risk factors at different stages in life., Childhood adversity, stress sensitivity, and psychosis: an experience sampling study, The childhood adversity and psychosis study (CAPsy) study: Integrating society, psychology and biology to investigate links between childhood adversity and psychosis, The Cambridge-UCL Mental Health and Neurosciences Network., European Network of National Schizophrenia Networks Studying Gene-Environment Interactions
OpenAlex ID: W2170663130