AIM: We conducted a matched-cohort study to assess mortality in schizophrenia and
the relationship of mortality with comorbid somatic conditions and suicide attempts.
METHOD: A full-population register-based prospective matched-cohort study was performed
including all eligible patients with schizophrenia in Hungary between 01/01/2005 and
31/12/2013. Control subjects were individually matched to patients with schizophrenia
at a 5:1 ratio. The principal outcome measure was death due to any reason. A non-parametric
approach was used for descriptive statistical purposes, the Kaplan-Meier model for
survival analysis, and the Cox proportional-hazards regression model for inferential
statistics. RESULTS: Patients with schizophrenia (n=65,169) had substantially higher
risk of all-cause mortality than the control subjects (n=325,435) (RR=2.4; P<0.0001).
Comorbidities and suicide attempts were associated with significantly increased mortality
in both groups. As compared to the controls, 20-year old males with schizophrenia
had a shorter life expectancy by 11.5years, and females by 13.7years; the analogous
numbers for 45-year old schizophrenics were 8.1 and 9.6years, respectively. CONCLUSIONS:
A significant mortality gap - mainly associated with somatic comorbidities - was detected
between patients with schizophrenia and individually matched controls. Improved medical
training to address the disparity in mortality, and many other factors including lack
of resources, access to and model of medical care, lifestyle, medication side effects,
smoking, stigma, need for early intervention and adequate health care organization
could help to better address the physical health needs of patients with schizophrenia.
