Bhatti Hurmat Fatima, Tahir Maham, Faheem Muhammad Shaheer Bin, Khabir Momina, Tahir Ali, Qureshi Muhammad Abdullah Aftab, Ashraf Danish Ali, Iqbal Muhammad Saad, Samadi Sumaya
Department of Internal Medicine, Foundation University Medical College, Islamabad, Pakistan.
Department of Internal Medicine, Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan.
Ann Med Surg (Lond). 2025 Jun 10;87(7):4336-4343. doi: 10.1097/MS9.0000000000003449. eCollection 2025 Jul.
Schizophrenia affects about 1% of the global population, with 1.5 million Americans diagnosed annually. Despite higher mortality rates in this group, trends by year, gender, and region remain insufficiently explored. This study evaluated global trends in schizophrenia (F20) mortality from 1999 to 2020, analyzing variations by year, gender, and region. Additionally, we examined age-adjusted mortality rates (AAMRs) by place of death and year to provide a comprehensive understanding of these trends.
The CDC WONDER database was used to analyze schizophrenia-related mortality from 1999 to 2020, calculating mortality rates and 95% confidence intervals (CIs) to assess national trends.
Throughout the study, males had higher AAMRs for schizophrenia (1.3%, 95% CI: 1.3-1.3) than females (0.9%, 95% Cl: 0.9-1.4). In metropolitan areas, the AAMR was 96.6, declining from 1999 to 2015 (APC: -1.07%) before rising (APC: 6.41%). Non-metropolitan areas had an AAMR of 58.9, decreasing from 1999 to 2017 (APC: -0.86%) before increasing by 2020 (APC: 8.95%). Overall, schizophrenia-related AAMRs rose from 1.2 in 1999 to 1.4 in 2020, with fluctuations.
Schizophrenia-related mortality declined from 1999 to 2015 but rose afterward. Males consistently had higher AAMRs, while urban areas showed greater mortality, reflecting social and environmental risks. Early declines may be linked to improved psychiatric care, whereas the recent rise correlates with the opioid epidemic and COVID-19. These findings highlight the need for better investment in mental health care, early intervention, access in underserved areas, and better management of comorbidities.
精神分裂症影响着全球约1%的人口，每年有150万美国人被诊断出患有此病。尽管该群体的死亡率较高，但按年份、性别和地区划分的趋势仍未得到充分研究。本研究评估了1999年至2020年精神分裂症（F20）死亡率的全球趋势，分析了按年份、性别和地区的差异。此外，我们还按死亡地点和年份检查了年龄调整死亡率（AAMR），以全面了解这些趋势。
使用疾病控制与预防中心（CDC）的WONDER数据库分析1999年至2020年与精神分裂症相关的死亡率，计算死亡率和95%置信区间（CI）以评估全国趋势。
在整个研究期间，男性精神分裂症的年龄调整死亡率（AAMR）（1.3%，95%CI：1.3 - 1.3）高于女性（0.9%，95%CI：0.9 - 1.4）。在大都市地区，年龄调整死亡率为96.6，从1999年至2015年下降（年度百分比变化率[APC]：-1.07%），之后上升（APC：6.41%）。非大都市地区的年龄调整死亡率为58.9，从1999年至2017年下降（APC：-0.86%），到2020年上升（APC：8.95%）。总体而言，与精神分裂症相关的年龄调整死亡率从1999年的1.2上升到2020年的1.4，有波动。
与精神分裂症相关的死亡率在从1999年至2015年下降，但之后上升。男性的年龄调整死亡率一直较高，而城市地区的死亡率更高，反映了社会和环境风险。早期的下降可能与精神科护理的改善有关，而近期的上升与阿片类药物流行和新冠疫情有关。这些发现凸显了在精神卫生保健方面加大投资、早期干预、改善服务不足地区的可及性以及更好地管理合并症的必要性。
