Differences in mortality and suicidal behaviour between treated and never-treated people with schizophrenia in rural China.
BACKGROUND
Many people with schizophrenia remain untreated in the community. Long-term mortality and suicidal behaviour among never-treated individuals with schizophrenia in the community are unknown.


OBJECTIVE
To explore 10-year mortality and suicidal behaviour among never-treated individuals with schizophrenia.


METHODS
We used data from a 10-year prospective follow-up study (1994-2004) among people with schizophrenia in Xinjin County, Chengdu, China.


RESULTS
The mortality rate for never-treated individuals with schizophrenia was 2761 per 100 000 person-years during follow-up. There were no significant differences of rates of suicide and all-cause mortality between never-treated and treated individuals. The standardised mortality ratio (SMR) for never-treated people was 10.4 (95% CI 7.2-15.2) and for treated individuals 6.5 (95% CI 5.2-8.5). Compared with treated people, never-treated individuals were more likely to be older, poorer, have a longer duration of illness, marked symptoms and fewer family members.


CONCLUSIONS
The never-treated individuals have similar mortality to and a higher proportion of marked symptoms than treated people, which may reflect the poor outcome of the individuals without treatment. The higher rates of mortality, homelessness and never being treated among people with schizophrenia in low- and middle-income nations might challenge presumed wisdom about schizophrenia outcomes in these countries.
Ran
Mao-Sheng
MS
Division of Social Work, University of Guam, Mangilao, Guam 96923, USA. ranmaosh@yahoo.com
Chan
Cecilia Lai-Wan
CL
Chen
Eric Yu-Hai
EY
Mao
Wen-Jun
WJ
Hu
Shi-Hui
SH
Tang
Cui-Ping
CP
Lin
Fu-Rong
FR
Conwell
Yeates
Y
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000401:mortality* / Q000628:therapy; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012931:Social Environment; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult