Patients with schizophrenia face shorter lives, greater cardiovascular risk

Despite an overall decline in mortality of individuals who suffer from schizophrenia, patients living with the mental illness are still experiencing shorter lives and have a higher rate of cardiovascular disease (CVD) than the general population, according to a new study published in the Canadian Medical Association Journal.

Deaths in patients with schizophrenia have declined over the past two decades, lead study author Paul A. Kurdyak, MD, PhD, and colleagues wrote, but these people still live an average of eight years less than those without the disease.

Kurdyak and co-authors analyzed mortality data from 1993 through 2012, evaluating cause of death for all recorded fatalities in Ontario, Canada, during that time. The researchers split data into two groups: individuals with and without schizophrenia. After adjusting the numbers to fit mortality rate ratios, the authors found the 31,349 patients with schizophrenia were three times more likely to die sooner than the 1,589,902 people without it.

All-cause age- and sex-standardized mortality rates (ASMRs) declined among the entire study population during the 20 years, decreasing by 35 percent in both groups. Rates declined the most among men, residents living in rural areas and those with low income.

Still, cause-specific death rates were greatest among people living with schizophrenia. The majority of deaths in this cohort were caused by circulatory conditions, the study stated, while in the population without schizophrenia, neoplasms like cancer became the biggest killer after 2005.

Obesity and diabetes also proved to be more prominent in patients with schizophrenia. A sedentary lifestyle, smoking and medications that can cause weight gain and contribute to overall poorer health.

“Our study shows that individuals with schizophrenia are not benefiting from public health and healthcare interventions to the same degree as individuals without schizophrenia,” Kurdyak said in a release from the Centre for Addiction and Mental Health (CAMH). “As healthcare providers, it is our responsibility to work together across our healthcare system to provide these patients with better, integrated physical and mental healthcare. By not doing so, there are dire, tragic consequences and shortened lives.”

Eugene Rubin, MD, PhD, wrote in a 2016 Psychiatry Today article, the global population generally lives 25 years longer than individuals with schizophrenia, and those who live with the disorder tend to live just 70 percent of a “normal” life span.

Citing a JAMA Psychiatry study, Rubin wrote the most common causes of death in patients with schizophrenia are CVD, cancer, diabetes, influenza, accidental deaths and suicides. Suicide rates were elevated compared to the general population, but didn’t make up the majority of mortalities by a long shot.

Kurdyak said in the CAMH release that while progress is made toward reducing CVD globally, the demographic living with schizophrenia is not seeing many benefits.

“It seems that people with schizophrenia haven’t benefited from the advances that we have made for patients living with chronic physical illnesses in the general population,” Kurdyak said. “A healthcare system that can address the mortality gap we have observed in this study would truly be a high-performing healthcare system."