Popa Andreea-Violeta, Ifteni Petru Iulian, Țâbian Daniel, Petric Paula Simina, Teodorescu Andreea
Faculty of Medicine, Transilvania University of Brasov, Brasov, Romania.
Clinical Hospital of Psychiatry and Neurology of Brașov, Brasov, Romania.
Schizophrenia (Heidelb). 2025 Aug 29;11(1):117. doi: 10.1038/s41537-025-00667-1.
Individuals with schizophrenia face significantly higher mortality rates than the general population, with a typical reduction in life expectancy of 15-20 years. This study investigated 10-year all-cause mortality and its clinical correlates in a Romanian cohort of patients with schizophrenia, using real-world clinical and hospital and forensic records. A total of 635 individuals hospitalized between 2010 and 2013 were followed for 10 years. Mortality rates, causes of death, and risk factors were assessed using Cox regression models and standardized mortality ratios (SMRs). During the follow-up, 123 patients (19.37%) died, corresponding to a mortality rate of 21.3 per 1000 person-years. The SMR was 1.58 compared to the Romanian general population. Non-violent causes predominated, with cardiovascular disease (27.64%) and infections (17.07%) being the most frequent. Violent deaths, including suicides and accidents, accounted for 17.07% of all mortality. The mean age at death was 58.97 years, reflecting a 17-year reduction in life expectancy. Age was the strongest independent predictor of mortality (HR = 1.07, p < 0.001). Use of second-generation antipsychotics (HR = 0.37, p < 0.001) and low frequency hospitalization (HR = 0.09, p < 0.001) were significantly associated with reduced all-cause and cause-specific mortality. Schizophrenia is associated with significantly increased premature mortality, primarily due to preventable physical illnesses and violent deaths. Early intervention, sustained treatment adherence, and integrated medical care are essential to improve survival outcomes.
精神分裂症患者的死亡率显著高于普通人群，预期寿命通常会缩短15至20年。本研究利用真实世界的临床、医院和法医记录，调查了罗马尼亚一组精神分裂症患者的10年全因死亡率及其临床相关因素。对2010年至2013年间住院的635名个体进行了为期10年的随访。使用Cox回归模型和标准化死亡率（SMR）评估死亡率、死亡原因和风险因素。在随访期间，123名患者（19.37%）死亡，死亡率为每1000人年21.3例。与罗马尼亚普通人群相比，SMR为1.58。非暴力原因占主导，心血管疾病（27.64%）和感染（17.07%）最为常见。包括自杀和事故在内的暴力死亡占所有死亡人数的17.07%。平均死亡年龄为58.97岁，反映出预期寿命缩短了17年。年龄是死亡率最强的独立预测因素（HR = 1.07，p < 0.001）。使用第二代抗精神病药物（HR = 0.37，p < 0.001）和低频率住院（HR = 0.09，p < 0.001）与全因死亡率和特定原因死亡率的降低显著相关。精神分裂症与过早死亡率显著增加有关，主要是由于可预防的身体疾病和暴力死亡。早期干预、持续的治疗依从性和综合医疗护理对于改善生存结果至关重要。
