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Schizophrenics more likely to die prematurely of heart disease, cancer

The average life expectancy of men and women with schizophrenia was 15 years and 12 years shorter, respectively, than with those without the illness, according to recent study results. Leading causes of death among this population were ischemic heart disease and cancer, although those with schizophrenia had contact with health services more than twice as often as their healthy counterparts.

“It is unacceptable that such a vulnerable group of people who also have extensive documented contact with the health service should die prematurely of conditions such as cardiovascular disease and cancer — diseases that should be preventable,” study researcher Kristina Sundquist, MD, PhD, general practitioner and professor at the Centre for Primary Health Care Research at Lund University in Sweden, said in a press release. “A much greater degree of diagnostic and preventive measures could be put in place for this vulnerable group in our society.”

Sundquist and colleagues examined data from a Swedish national cohort study of 6,097,834 adults, including 8,277 with schizophrenia, who were followed for 7 years. Mortality and comorbidities — including hypertension, ischemic heart disease, stroke, cancer, diabetes mellitus, lipid disorders, influenza or pneumonia, chronic obstructive pulmonary disease and liver disease — were diagnosed in any outpatient or inpatient setting in Sweden.

Results indicated that women with schizophrenia were 3.3 times more likely to die of ischemic heart disease (95% CI, 2.73-4.05), and men 2.2 times more likely (95% CI, 1.83-2.65), than those without schizophrenia. Women with schizophrenia were 1.7 times more likely (95% CI, 1.39-2.1), and men 1.4 times more likely (95% CI, 1.15-1.8), to die of cancer.

Among patients who died of ischemic heart disease or cancer, those with schizophrenia were less likely to have been diagnosed with those illnesses compared with others (ischemic heart disease=26.3% vs. 43.7%; cancer=73.9% vs. 82.3%). The association between schizophrenia and mortality was stronger among women (P=.005) and among those who were currently employed (P=.007). Lack of antipsychotic treatment was also associated with an elevated risk for mortality (adjusted HR=1.45; 95% CI, 1.2-1.76).

The researchers said the greater risk for mortality among patients with schizophrenia despite their having more frequent contact with health services may be due to substantial underdiagnosis or undertreatment, or both.

“Underdetection of important causes of mortality in schizophrenia patients in Sweden, despite universal health care, raises the question of whether it may be an even larger problem in countries without universal health care,” they wrote.

Disclosure: The researchers report no relevant financial disclosures.