Mortality in people with psychotic disorders in Finland: A population-based 13-year follow-up study

Autor: Jonna Perälä, Tommi Härkänen, Niina Markkula, Outi Mantere, Samuli I. Saarni, Krista Partti, Jaana Suvisaari, Jaakko Keinanen
Přispěvatelé: Clinicum, Department of Psychiatry, University of Helsinki, Children's Hospital, Nuorisopsykiatria, HUS Children and Adolescents, HUS Psychiatry
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
medicine.medical_treatment
Comorbidity
3124 Neurology and psychiatry
0302 clinical medicine
Risk Factors
Cause of Death
SCHIZOPHRENIA
Finland
GENERAL-POPULATION
education.field_of_study
Medical record
Hazard ratio
Follow up studies
BIPOLAR DISORDER
Middle Aged
C-REACTIVE PROTEIN
3. Good health
Psychiatry and Mental health
Schizophrenia
Female
Antipsychotic Agents
Adult
medicine.medical_specialty
Population
SWEDISH NATIONAL COHORT
ILLNESS
03 medical and health sciences
Internal medicine
MENTAL-DISORDERS
Interview
Psychological
medicine
Humans
CORONARY-HEART-DISEASE
Bipolar disorder
Mortality
Antipsychotic
education
Psychiatry
Socioeconomic status
Life Style
METAANALYSIS
Biological Psychiatry
Aged
Proportional Hazards Models
Proportional hazards model
business.industry
Somatic disease
medicine.disease
COMORBIDITIES
ta3124
030227 psychiatry
Nap
Psychotic Disorders
Socioeconomic Factors
Smoking cessation
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Schizophrenia Research. 192:113-118
ISSN: 0920-9964
0924-9338
Popis: IntroductionPeople with psychotic disorders have increased mortality compared to the general population. The mortality is mostly due to natural causes and it is disproportionately high compared to the somatic morbidity of people with psychotic disorders.ObjectivesWe aimed to find predictors of mortality in psychotic disorders and to evaluate the extent to which sociodemographic and health-related factors explain the excess mortality.MethodsIn a nationally representative sample of Finns aged 30–70 years (n = 5642), psychotic disorders were diagnosed in 2000–2001. Information on mortality and causes of death was obtained of those who died by the end of year 2013. Cox proportional hazards models were used to investigate the mortality risk.ResultsAdjusting for age and sex, diagnosis of nonaffective psychotic disorder (NAP) (n = 106) was statistically significantly associated with all-cause mortality (HR 2.99, 95% CI 2.03–4.41) and natural-cause mortality (HR 2.81, 95% CI 1.85–4.28). After adjusting for sociodemographic factors, health status, inflammation and smoking, the HR dropped to 2.11 (95% CI 1.10–4.05) for all-cause and to 1.98 (95% CI 0.94–4.16) for natural-cause mortality. Within the NAP group, antipsychotic use at baseline was associated with reduced HR for natural-cause mortality (HR 0.25, 95% CI 0.07–0.96), and smoking with increased HR (HR 3.54, 95% CI 1.07–11.69).ConclusionsThe elevated mortality risk associated with NAP is only partly explained by socioeconomic factors, lifestyle, cardiometabolic comorbidities and inflammation. Smoking cessation should be prioritized in treatment of psychotic disorders. More research is needed on the quality of treatment of somatic conditions in people with psychotic disorders.Disclosure of interestJaakko Keinänen owns shares in pharmaceutical company Orion.
Databáze: OpenAIRE
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