Life expectancy reduced in schizophrenia, bipolar disorder patients
By Mark Cowen
22 July 2011
Schizophr Res 2011; Advance online publication

MedWire News: Results from a Danish study show that individuals with schizophrenia or bipolar disorder have a significantly shorter life expectancy than the general population, indicating an increased need for healthcare services to address the physical health problems of this patient group.

Writing in the journal Schizophrenia Research, Thomas Munk Laursen (Aarhus University, Denmark) explains that previous studies have consistently shown that patients with schizophrenia or bipolar disorder have a mortality rate ratio (MRR) of approximately 2 to 3 times higher than the general population.

He adds: "Mortality rate ratios (MRRs) for suicide are particularly high (approximately 20) and thus suicide has received much attention in the investigation of excess mortality among psychiatric patients.

"However, an MRR of 20.0 for suicide and an MRR of 2.5 for all-cause mortality tend to conceal the importance and impact of mortality from physical diseases and medical conditions."

Laursen explains that an alternative approach to measuring the excess mortality among people with schizophrenia and bipolar disorder is to calculate the years of potential life lost. This method accounts for the effect of very common causes of death with relatively low excess mortality, gives more weight to deaths that occur among younger persons, and presents a straightforward and understandable measure of the magnitude of the excess mortality.

To this end, Laursen used data from the Danish Civil Registration System and the Danish Psychiatric Central Register to compare life expectancy rates between patients diagnosed with schizophrenia or bipolar disorder and the general population.

Data on a total of 5,036,662 individuals were examined for the period 2000-2006, of whom 31,727 had schizophrenia and 17,037 bipolar disorder. In total, 400,575 individuals died during the period, including 4247 with schizophrenia and 3223 with bipolar disorder.

Survival analysis techniques revealed that life expectancy among men and women with schizophrenia was a respective 18.7 and 16.3 years shorter than that among men and women in the general population.

Furthermore, life expectancy among men and women with bipolar disorder was a respective 16.3 and 13.6 years shorter than that among those in the general population.

Laursen concludes: "The findings in this paper emphasize an apparent need for a greater focus on the physical health needs of this population, because their shortened lifespan stems largely from excess mortality by physical diseases and medical conditions, and to a much lesser degree from external causes of death.

"However, it is also clear that any plan for reducing their unacceptably short lifespan would only be effective if it incorporated a broad range of preventive measures."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

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