Eli Lilly and Company Ltd, Basingstoke, UK.
J Psychopharmacol. 2010 Nov;24(4 Suppl):17-25. doi: 10.1177/1359786810382468.
Over the last five years, large data sets on mortality in schizophrenia have been published which have established mortality as a measurable clinical endpoint. Four issues need clarification: whether mortality rates are declining, what the causes of death are, the effects antipsychotic treatments have on mortality and whether these data inform as to how mortality may be reduced in the future. A PubMed search was carried out to identify relevant publications. The search strategy was conducted as a review focusing predominantly on data since 2006. A large number of retrospective epidemiological and prospective studies have been published on mortality rates and causation in schizophrenia, predominantly from 2006-2009. Data suggest that the mortality gap with the general population increased from the 1970s but may have peaked in the mid-1990s. The main causes of mortality are suicide, cancer and cardiovascular disease, with evidence that cancer mortality rates are similar to cardiovascular mortality rates. Mortality causation is dependent upon age of the cohort, length of follow up and type of study. Antipsychotic treatments reduce mortality when compared with no treatment and atypical antipsychotics do not appear to increase cardiovascular mortality and morbidity compared with conventionals; further research is required for any definitive conclusion.
在过去的五年中，已经发表了大量关于精神分裂症死亡率的大型数据集，这些数据集已经将死亡率确立为可衡量的临床终点。有四个问题需要澄清：死亡率是否正在下降、死亡原因是什么、抗精神病药物治疗对死亡率的影响以及这些数据是否为未来降低死亡率提供了信息。进行了一项 PubMed 搜索以确定相关出版物。搜索策略主要是作为一项综述进行的，主要关注 2006 年以来的数据。大量关于精神分裂症死亡率和病因的回顾性流行病学和前瞻性研究已经发表，主要集中在 2006 年至 2009 年。数据表明，自 20 世纪 70 年代以来，与普通人群的死亡率差距有所增加，但可能在 20 世纪 90 年代中期达到顶峰。主要的死亡原因是自杀、癌症和心血管疾病，有证据表明癌症死亡率与心血管死亡率相似。死亡率的病因取决于队列的年龄、随访时间和研究类型。与不治疗相比，抗精神病药物治疗可降低死亡率，与传统药物相比，非典型抗精神病药物似乎不会增加心血管死亡率和发病率；需要进一步研究才能得出任何明确的结论。
