Mortality in schizophrenia and schizoaffective disorder: an Olmsted County, Minnesota cohort: 1950-2005.
BACKGROUND
Increased mortality in people with schizophrenia, compared to the general population, has been consistently reported worldwide. This mortality has been attributed predominantly to "unnatural" deaths-suicide, accidents, and homicide. Recent studies have shown an increase in natural causes of death. Our objective is to compare the mortality of schizophrenic and schizoaffective subjects to the general US population.


METHODS
319 Olmsted County residents meeting DSM-IV-TR criteria for schizophrenia or schizoaffective disorder seen at the Mayo Clinic between 1950 and 1980 were followed until February 2005 for a median of 23.5 years.


RESULTS
At the end of follow-up, 44% of patients were deceased. Mortality was significantly (p<0.001) increased compared to the Caucasian population in the US for persons of like age, gender, and calendar year of birth. The median survival following diagnosis was 36.2 years. Death certificate cited cause of death was cardiac (29%), cancer--including lung (19%), and pulmonary disease (17%). Concerningly, there was no association with the year of diagnosis to survival.


CONCLUSIONS
Tsuang and colleagues showed in 1975 that mortality in schizophrenics and later, those with schizoaffective disorder was significantly increased compared to the US general population. Thirty years later, with a demographically similar population, we have found the same pattern of increased mortality. In light of continued improvements in the general population's lifespan, the survival gap in schizophrenia/schizoaffective disorder appears to be increasing.
Capasso
Rebecca M
RM
Mayo Clinic School of Medicine, Department of Psychiatry and Psychology, Rochester, MN 55905, USA.
Lineberry
Timothy W
TW
Bostwick
J Michael
JM
Decker
Paul A
PA
St Sauver
Jennifer
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death / Q000639:trends; D002648:Child; D015331:Cohort Studies; D003644:Death Certificates; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006331:Heart Diseases / Q000401:mortality; D006801:Humans; D008171:Lung Diseases / Q000401:mortality; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009369:Neoplasms / Q000401:mortality; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000401:mortality*; D012559:Schizophrenia / Q000175:diagnosis / Q000401:mortality*; D015996:Survival Rate; D014481:United States