Yu Chuan-Hsun, Hsieh Tsung-Cheng
Department of General Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan.
Institute of Medical Sciences, Tzu-Chi University, Hualien, Taiwan.
BJPsych Open. 2024 Oct 8;10(5):e166. doi: 10.1192/bjo.2024.796.
Research on schizophrenia and life expectancy has mainly focused on premature mortality.
This study investigates factors associated with longevity in patients with schizophrenia receiving long-term care and identifies shared traits among these individuals.
A retrospective cross-sectional study analysing the clinical records of 138 patients with schizophrenia who died between 2015 and 2017 in a psychiatric long-term care facility was conducted. Longevity was defined by life tables drawn from the national health database. Variables were compared between longevity and control groups to determine predictors of longer lifespans. Cluster analysis was employed to identify shared traits among individuals with longevity. Causes of death by age were compared.
In the long-term care setting, of the 138 participants, 45 were in the longevity group. This group had more males, lower antipsychotic doses, but more mobility issues. Significant predictors of longevity included older age at onset, longer length of stay, lower activities of daily living scores and a hypertension diagnosis. Cluster analysis revealed two patterns, suggesting that poorer health indicators did not necessarily lead to shorter lives. Fatalities caused by pneumonia were associated with a higher age, compared to those from cancer and choking.
Addressing modifiable risk factors enhances life expectancy in patients with schizophrenia, especially for males, while the age at onset may play a significant role. An integrated long-term care model with close monitoring and timely provision of mental and general healthcare may help extend lifespans. Further research is needed to balance long-term residential care and community-based care for elderly patients with schizophrenia.
关于精神分裂症与预期寿命的研究主要集中在过早死亡方面。
本研究调查接受长期护理的精神分裂症患者中与长寿相关的因素,并确定这些个体的共同特征。
进行了一项回顾性横断面研究,分析了2015年至2017年间在一家精神科长期护理机构死亡的138例精神分裂症患者的临床记录。通过国家健康数据库绘制的生命表来定义长寿。比较长寿组和对照组之间的变量,以确定较长寿命的预测因素。采用聚类分析来识别长寿个体的共同特征。比较不同年龄的死亡原因。
在长期护理环境中,138名参与者中,45人属于长寿组。该组男性较多,抗精神病药物剂量较低,但行动不便问题较多。长寿的显著预测因素包括发病年龄较大、住院时间较长、日常生活活动得分较低以及患有高血压。聚类分析揭示了两种模式,表明较差的健康指标不一定导致较短的寿命。与癌症和窒息导致的死亡相比,肺炎导致的死亡与较高年龄相关。
解决可改变的风险因素可提高精神分裂症患者的预期寿命,尤其是男性,而发病年龄可能起重要作用。一个综合的长期护理模式,密切监测并及时提供精神和一般医疗保健,可能有助于延长寿命。需要进一步研究以平衡老年精神分裂症患者的长期住院护理和社区护理。