Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Grupo GAP, Facultad de Psicología, Universidad de Málaga, Spain.
Department of Mental Health, University General Hospital of Malaga. Biomedical Research Institute of Malaga (IBIMA), Spain.
Epidemiol Psychiatr Sci. 2021 Feb 4;30:e11. doi: 10.1017/S2045796020001146.
There is evidence that patients with schizophrenia spectrum disorders present higher mortality in comparison with the general population. The aim of this study was to analyse the causes of mortality and sociodemographic factors associated with mortality, standardised mortality ratios (SMRs), life expectancy and potential years of life lost (YLL) in patients with schizophrenia spectrum disorders in Spain.
The study included a cohort of patients from the Malaga Schizophrenia Case Register (1418 patients; 907 males; average age 42.31 years) who were followed up for a minimum of 10 years (median = 13.43). The factors associated with mortality were analysed with a survival analysis using Cox's proportional hazards regression model.
The main causes of mortality in the cohort were circulatory disease (21.45%), cancer (17.09%) and suicide (13.09%). The SMR of the cohort was more than threefold that of the population of Malaga (3.19). The life expectancy at birth was 67.11 years old, which is more than 13 years shorter than that of the population of Malaga. The YLL was 20.74. The variables associated with a higher risk of mortality were age [adjusted hazard ratio (AHR) = 1.069, p < 0.001], male gender (AHR = 1.751, p < 0.001) and type of area of residence (p = 0.028; deprived urban zone v. non-deprived urban area, AHR = 1.460, p = 0.028). In addition, receiving welfare benefit status in comparison with employed status (AHR = 1.940, p = 0.008) was associated with increased mortality.
There is excess mortality in patients with schizophrenia spectrum disorders and also an association with age, gender, socioeconomic inequalities and receiving welfare benefits. Efforts directed towards improved living conditions could have a positive effect on reducing mortality.
有证据表明，精神分裂症谱系障碍患者的死亡率高于一般人群。本研究旨在分析西班牙精神分裂症谱系障碍患者的死亡原因和与死亡率相关的社会人口学因素、标准化死亡率比（SMR）、预期寿命和潜在寿命损失年数（YLL）。
该研究纳入了马拉加精神分裂症病例登记处的一个队列，共纳入 1418 名患者（907 名男性；平均年龄 42.31 岁），随访时间至少 10 年（中位数=13.43 年）。采用 Cox 比例风险回归模型对与死亡率相关的因素进行生存分析。
队列中主要的死亡原因是循环系统疾病（21.45%）、癌症（17.09%）和自杀（13.09%）。队列的 SMR 是马拉加人口的三倍多（3.19）。出生时的预期寿命为 67.11 岁，比马拉加人口少 13 岁以上。YLL 为 20.74。与死亡率较高相关的变量包括年龄[调整后的风险比（AHR）=1.069，p<0.001]、男性（AHR=1.751，p<0.001）和居住地区类型（p=0.028；贫困城区与非贫困城区，AHR=1.460，p=0.028）。此外，与就业状态相比，领取福利金状态（AHR=1.940，p=0.008）与死亡率增加相关。
精神分裂症谱系障碍患者的死亡率过高，且与年龄、性别、社会经济不平等和领取福利金有关。改善生活条件的努力可能对降低死亡率产生积极影响。
