Joukamaa Matti, Heliövaara Markku, Knekt Paul, Aromaa Arpo, Raitasalo Raimo, Lehtinen Ville
Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, FIN-33014, Finland.
Br J Psychiatry. 2006 Feb;188:122-7. doi: 10.1192/bjp.188.2.122.
There is an excess of death from natural causes among people with schizophrenia.
Schizophrenia and its treatment with neuroleptics were studied for their prediction of mortality in a representative population sample of 7217 Finns aged >/= 30 years.
A comprehensive health examination was carried out at baseline. Schizophrenia was determined using the Present State Examination and previous medical records.
During a 17-year follow-up, 39 of the 99 people with schizophrenia died. Adjusted for age and gender, the relative mortality risk between those with schizophrenia and others was 2.84 (95% CI 2.06-3.90), and was 2.25 (95% CI1.61-3.15) after further adjusting for somatic diseases, bloodpressure, cholesterol, body mass index, smoking, exercise, alcohol intake and education. The number of neuroleptics used at the time of the baseline survey showed a graded relation to mortality. Adjusted for age, gender, somatic diseases and other potential risk factors for premature death, the relative risk was 2.50 (95% CI1.46-4.30) per increment of one neuroleptic.
There is an urgent need to ascertain whether the high mortality in schizophrenia is attributable to the disorder itself or the antipsychotic medication.
精神分裂症患者的自然原因死亡率过高。
在一个由7217名年龄≥30岁的芬兰人组成的代表性人群样本中，研究精神分裂症及其使用抗精神病药物治疗对死亡率的预测作用。
在基线时进行全面的健康检查。使用现况检查和既往病历确定精神分裂症。
在17年的随访期间，99名精神分裂症患者中有39人死亡。经年龄和性别调整后，精神分裂症患者与其他人之间的相对死亡风险为2.84（95%可信区间2.06 - 3.90），在进一步对躯体疾病、血压、胆固醇、体重指数、吸烟、运动、饮酒量和教育程度进行调整后为2.25（95%可信区间1.61 - 3.15）。基线调查时使用的抗精神病药物数量与死亡率呈分级关系。经年龄、性别、躯体疾病和其他过早死亡的潜在风险因素调整后，每增加一种抗精神病药物，相对风险为2.50（95%可信区间1.46 - 4.30）。
迫切需要确定精神分裂症的高死亡率是归因于该疾病本身还是抗精神病药物治疗。
