SAN DIEGO – A new systematic review and meta-analysis, the first of its kind, suggests that most people with schizophrenia – especially men – do not survive past their 60s.
According to findings released at the 2017 International Congress on Schizophrenia Research, schizophrenia patients appear to die a weighted average of 14.5 years earlier than the rest of the population (95% confidence interval, 11.2-17.8).
The weighted average life expectancy for schizophrenia patients was 64.7 years (95% CI, 61.1-71.3) – 59.9 years for men (95% CI, 55.5-64.3) and 67.6 years for women (95% CI, 63.1-72.1).
“There were no indications that this is improving over time,” lead author Carsten Hjorthøj, PhD, senior researcher at the University of Copenhagen, said in an interview.
The researchers launched their paper in order to provide a wider perspective on lives lost in schizophrenia.
Previous studies had used measures like the standardized mortality ratio, which compared schizophrenia patients with a matched group from the general population, Dr. Hjorthøj said. “Saying that people with schizophrenia are, for instance, 2.5 times more likely to die at any given age may be a little difficult to understand. Identifying the actual number of years they die earlier than the rest of the population is easily understood and will probably also make the issue more obvious to policymakers.”
The researchers, whose findings were previously published in Lancet Psychiatry (2017 Apr;4[4]:295-301), examined 11 studies, mostly from Europe (n = 5) and North America (n = 3) with single studies from Africa, Asia, and Australia. (The lowest life expectancies were reported in Asia and Africa.)
One study was published in 1991, and the rest from 2001-2016. Together, the studies tracked 302,691 patients with schizophrenia.
What explains the gap between the life expectancies in men and women? “We did not investigate the reasons for this,” Dr. Hjorthøj said, “but men typically have worse adherence to treatment than women, and men typically also have poorer health-seeking behavior than women even in the general population. Given that schizophrenia is associated with a multitude of adverse somatic outcomes, this could then be aggravated by this difference in health-seeking behavior.”
In addition, he said, “It could also be the case that use of alcohol, tobacco, and illicit substances is even more skewed in schizophrenia than in the general population. Finally, it could also be attributed in part to the fact that men are more likely than women to die from suicide.”
Dr. Hjorthøj said that the findings emphasize the importance of treating physical symptoms in people with schizophrenia.
“I am aware of several cases where physical complaints were not taken seriously because they were raised by people who were known to suffer from delusions,” he said. “But, I do believe that most psychiatrists are aware of this, and the problem is perhaps more that the system in general is underfunded and that somatic and psychiatric hospitals are not good enough at communicating with each other.”
The researchers report no funding and no disclosures.