title: Standardized Mortality Ratio in Patients with Schizophrenia - Findings from Thirthahalli: A Rural South Indian Community.
abstract: BACKGROUND
  Schizophrenia is associated with excess mortality experience than the general population. Though this is one of the important outcome measures, it has not been adequately explored especially in rural community dwelling patients in India. We describe the standardized mortality ratio (SMR) of a cohort of schizophrenia patients of Thirthahalli, one such rural taluk of South India.
  
  
  METHODS
  SMRs for the years 2009-2011 were calculated. A number of patients in the cohort were 301, 317, and 325 for those consecutive years, respectively. Observed deaths among the patients were noted for these years separately. Crude death rates (CDRs) of the general population of Shimoga district were obtained from the Statistics Department of the Government of Karnataka. CDR (per 1000) was multiplied by the number of patients in each year to get the expected deaths. Then, observed deaths were divided by the expected deaths to get the SMR.
  
  
  RESULTS
  There were totally 12 deaths among the patients in these 3 years. SMRs for the years 2009, 2010, and 2011 were respectively 1.4, 1.8, and 2.2. Six had died out of natural (medical) causes. Four had committed suicide, and one died from an accident. Cause from one death remained unknown. There was no statistically significant difference between the alive and deceased patients in any of the demographic or clinical variables.
  
  
  CONCLUSIONS
  Mortality among schizophrenia patients in this rural cohort is considerably lower than patients from developed countries. Nevertheless, nearly two-fold excess mortality in schizophrenia calls for attention to their medical and psychosocial needs.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Virupakshappa Irappa
authors.initials: VI
authors.lastname: Bagewadi
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: C Naveen
authors.initials: CN
authors.lastname: Kumar
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Jagadisha
authors.initials: J
authors.lastname: Thirthalli
authors.affiliation: Department of Epidemiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Girish N
authors.initials: GN
authors.lastname: Rao
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Suresha
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: B N
authors.initials: BN
authors.lastname: Gangadhar
keywords: Mortality; schizophrenia; standardized mortality ratio