title: Life expectancy and death by diseases of the circulatory system in patients with bipolar disorder or schizophrenia in the Nordic countries.
abstract: OBJECTIVE
  Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause specific Standardized Mortality Rates (SMRs) were calculated for each specific subgroup of mortality. Life expectancy was calculated using Wiesler's method.
  
  
  RESULTS
  The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes. SMR was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark. Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter.
  
  
  CONCLUSIONS
  Our data show that persons in the Nordic countries with schizophrenia or bipolar disorder have a substantially reduced life expectancy. An evaluation of the reasons for these increased mortality rates should be prioritized when planning healthcare in the coming years.
authors.affiliation: National Centre for Register-based Research, Aarhus University, Aarhus, Denmark. tml@ncrr.dk
authors.forename: Thomas Munk
authors.initials: TM
authors.lastname: Laursen
authors.forename: Kristian
authors.initials: K
authors.lastname: Wahlbeck
authors.forename: Jonas
authors.initials: J
authors.lastname: Hällgren
authors.forename: Jeanette
authors.initials: J
authors.lastname: Westman
authors.forename: Urban
authors.initials: U
authors.lastname: Ösby
authors.forename: Hassan
authors.initials: H
authors.lastname: Alinaghizadeh
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
mesh_terms: D001714:Bipolar Disorder / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002319:Cardiovascular System / Q000473:pathology*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D012559:Schizophrenia / Q000401:mortality*