Schizophrenia: a life-shortening disease.

The author reviews a number of studies which have shown that the overall mortality among patients with schizophrenia is about twice that in the general population. The highest excess mortality is found in suicide and violent death, but there seems to be an increased mortality also in cardiovascular disorders. Whether there is an increased mortality in cancer among schizophrenic patients remains a controversial issue. A reduced mortality, and particularly a reduced suicide rate, must be an important aim for any treatment policy or therapeutic program. The use of computerized patient data bases, linked to cause-of-death registers, is recommended to permit regular followup studies of large patient populations and facilitate the access to medical records and death records for more detailed analyses. A 10-year followup of 1,190 patients with schizophrenia, selected from the Stockholm County inpatient register is described. The overall mortality was more than twice that in the general population, and the mortality in suicide was more than 10 times higher. The inpatient register was used to identify hospital episodes. Medical records were then obtained for studies on the validity of diagnoses and causes of death and for analyses of risk factors for suicide.