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Mortality among persons with schizophrenia in Sweden: An epidemiological study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
2007 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 4, 252-259 p.Article in journal (Refereed) Published
Abstract [en]

The objective of the study was to analyse 10-year mortality among persons with schizophrenia from an epidemiological perspective. This cohort study included all persons with schizophrenia (n=255) living in the northern catchment area in Uppsala in 1991, and 1275 subjects from the national population register matched for sex, age and living area. The prevalence of schizophrenia was 0.37% and the mortality rate for individuals with schizophrenia was higher than for referents: 23.0% vs. 11.2%. The higher mortality among those with schizophrenia was mainly the result of unnatural causes and cardiovascular disease, especially in men. Excess mortality from cardiovascular disease was more pronounced in middle age, irrespective of gender. Multivariate analysis revealed higher mortality among individuals with schizophrenia living in the city than among those living in less urbanized areas. People with schizophrenia die more often than those without schizophrenia from unnatural causes or circulatory diseases. Individuals with schizophrenia die sooner from circulatory diseases than those without schizophrenia. Having schizophrenia and living in the city also results in higher mortality than having schizophrenia and living in other areas. The risk of early death from circulatory disease needs to be studied in more detail to reveal the potential respective contributions of intrinsic patient vulnerability, lifestyle factors and side-effects from psychotropic drugs.

Place, publisher, year, edition, pages
2007. Vol. 61, no 4, 252-259 p.
Keyword [en]
Cardiovascular, Causes of death, Death rate, Mortality, Schizophrenia, Suicide, Urban
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-95440DOI: 10.1080/08039480701414932ISI: 000249182000003PubMedID: 17763118OAI: oai:DiVA.org:uu-95440DiVA: diva2:169641
Available from: 2007-01-30 Created: 2007-01-30 Last updated: 2011-01-21Bibliographically approved
In thesis
1. Long-Term Functional Psychosis: Epidemiology in Two Different Counties in Sweden
Open this publication in new window or tab >>Long-Term Functional Psychosis: Epidemiology in Two Different Counties in Sweden
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis is based on two independent studies, the first in Stockholm County (index year 1984; n=302), and the second, a replication and validation study, in Uppsala County (index year 1991; n=455).

The general aim was to study all individuals with Long-term Functional Psychosis (LFP) within the two counties of Sweden from an epidemiological perspective and to perform specific studies on a subgroup of individuals with schizophrenia. In the Stockholm study, the total one-year LFP prevalence was 5.3/1 000; in the the rural, suburban and urban areas it was 3.4, 5.6 and 6.6/1 000, respectively. The total one-year prevalence of LFP in Uppsala was 7.3/1 000; in the rural, peripheral city and central city areas it was 6.0, 7.0, and 8.7/1 000, respectively.

Within the non-schizophrenic subpopulation, a pronounced difference was demonstrated between the two studies with substantially higher prevalence rates in the Uppsala study. The schizophrenic subgroup in Uppsala was re-diagnosed using parallel diagnostic systems (DSM-III, DSM-III-R, DSM-IV and ICD-10), and reasonably comparable prevalence estimates were obtained.

In both studies antipsychotic drugs were most frequently prescribed for the patients with schizophrenia, and the doses were considered as low to moderate. In the Uppsala study the doses of antipsychotic drugs decreased with a longer duration of illness, while the opposite was found in the Stockholm study.

The increased mortality rate among patients with schizophrenia was mainly due to unnatural causes of death and cardiovascular diseases, particularly among males.

The main methodological differences between the two studies were in the sampling procedures. In the Uppsala study, a larger number of care facilities were screened, and a broader set of diagnostic criteria were used for identifying cases from different registers.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 77 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 223
Psychiatry, epidemiology, functional psychosis, schizophrenia, prevalence, rural-urban gradient, comparative study, antipsychotic drugs, diagnostic criteria, mortality, Psykiatri
urn:nbn:se:uu:diva-7466 (URN)978-91-554-6792-0 (ISBN)
Public defence
2007-02-22, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:15
Available from: 2007-01-30 Created: 2007-01-30Bibliographically approved

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Fors, Björn MilessonIsacson, DagBingefors, KerstinWiderlöv, Birgitta
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