Center for Primary Health Care Research, Lund University, Lund, Sweden.
Department of Clinical Microbiology, Center of Diagnostic Investigations, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Bipolar Disord. 2023 Sep;25(6):489-498. doi: 10.1111/bdi.13309. Epub 2023 Feb 15.
The aim was to explore the association between neighborhood deprivation and all-cause mortality and cause-specific mortalities in patients with schizophrenia and bipolar disorder. A better understanding of this potential relationship may help to identify patients with schizophrenia and bipolar disorder with an increased mortality risk.
This nationwide study included practically all adults (≥30 years) diagnosed with schizophrenia (n = 34,544) and bipolar disorder (n = 64,035) in Sweden (1997-2017). The association between neighborhood deprivation and mortality was explored using Cox regression. All models were conducted in both men and women and adjusted for individual-level sociodemographic factors and comorbidities.
There was an association between level of neighborhood deprivation and all-cause mortality in both groups. The adjusted hazard ratios for all-cause mortality associated with high compared to low neighborhood deprivation were 1.18 (95% confidence interval 1.11-1.25) in patients with schizophrenia and 1.33 (1.26-1.41) in patients with bipolar disorder. The two most common mortality causes in both groups were coronary heart disease and cancer. The mortality due to coronary heart disease increased when neighborhood deprivation increased and reached 1.37 (1.18-1.60) in patients with schizophrenia and 1.70 (1.44-2.01) in patients with bipolar disorder living in the most deprived neighborhoods.
This study shows that neighborhood deprivation is an important risk factor for all-cause mortality and most cause-specific mortalities among patients with schizophrenia and bipolar disorder. These findings could serve as aid to policymakers when allocating healthcare resources and to clinicians who encounter patients with these conditions in deprived neighborhoods.
旨在探讨社区贫困与精神分裂症和双相情感障碍患者全因死亡率及特定死因死亡率之间的关联。更好地理解这种潜在的关系可能有助于识别具有更高死亡率风险的精神分裂症和双相情感障碍患者。
本项全国性研究纳入了瑞典所有（≥30 岁）被诊断患有精神分裂症（n=34544）和双相情感障碍（n=64035）的成年人。采用 Cox 回归分析来探讨社区贫困与死亡率之间的关系。所有模型均在男性和女性中进行，并调整了个体层面的社会人口统计学因素和合并症。
两组人群的社区贫困程度与全因死亡率均存在关联。与低社区贫困相比，与高社区贫困相关的全因死亡率的调整后危险比分别为精神分裂症患者 1.18（95%置信区间 1.11-1.25）和双相情感障碍患者 1.33（1.26-1.41）。两组人群中最常见的两种死亡原因是冠心病和癌症。随着社区贫困程度的增加，冠心病导致的死亡率也随之上升，精神分裂症患者的死亡率达到 1.37（1.18-1.60），双相情感障碍患者的死亡率达到 1.70（1.44-2.01）。
本研究表明，社区贫困是精神分裂症和双相情感障碍患者全因死亡率和大多数特定死因死亡率的一个重要危险因素。这些发现可以为政策制定者在分配医疗保健资源时提供帮助，也可以为在贫困社区遇到这些疾病患者的临床医生提供帮助。
