Mortality in people with psychotic disorders in Finland : A population-based 13-year follow-up study

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http://hdl.handle.net/10138/301091

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Keinänen , J , Mantere , O , Markkula , N , Partti , K , Perälä , J , Saarni , S I , Härkänen , T & Suvisaari , J 2018 , ' Mortality in people with psychotic disorders in Finland : A population-based 13-year follow-up study ' , Schizophrenia Research , vol. 192 , pp. 113-118 . https://doi.org/10.1016/j.schres.2017.04.048

Title: Mortality in people with psychotic disorders in Finland : A population-based 13-year follow-up study
Author: Keinänen, Jaakko; Mantere, Outi; Markkula, Niina; Partti, Krista; Perälä, Jonna; Saarni, Samuli I.; Härkänen, Tommi; Suvisaari, Jaana
Contributor: University of Helsinki, Clinicum
University of Helsinki, Children's Hospital
University of Helsinki, Clinicum
University of Helsinki, Department of Psychiatry
University of Helsinki, HUS Psychiatry
Date: 2018-02
Language: eng
Number of pages: 6
Belongs to series: Schizophrenia Research
ISSN: 0920-9964
URI: http://hdl.handle.net/10138/301091
Abstract: Objectives: We conducted a population based study aiming at finding predictors of mortality in psychotic disorders and evaluating the extent to which sociodemographic, lifestyle and health-related factors explain the excess mortality. Methods: In a nationally representative sample of Finns aged 30-70 years (n = 5642), psychotic disorders were diagnosed using structured interviews and medical records in 2000-2001. Information on mortality and causes of death was obtained of those who died by the end of year 2013. Cox proportional hazards models were used to investigate the mortality risk. Results: No people with affective psychoses (n = 36) died during the follow-up, thus the analysis was restricted to non-affective psychotic disorders (NAP) (n = 106). Adjusting for age and sex, NAP was statistically significantly associated with all-cause mortality (hazard ratio (HR) 2.99, 95% CI 2.03-441) and natural-cause mortality (HR 2.81, 95% CI 1.85-4.28). After adjusting for sociodemographic factors, health status, inflammation and smoking, the HR dropped to 2.11 (95%CI 1.10-4.05) for all-cause and to 1.98 (95% CI 0.94-4.16) for natural-cause mortality. Within the NAP group, antipsychotic use at baseline was associated with reduced HR for natural-cause mortality (HR 0.25, 95% CI 0.07-0.96), and smoking with increased HR (HR 3.54, 95% CI 1.07-11.69). Conclusions: The elevated mortality risk in people with NAP is only partly explained by socioeconomic factors, lifestyle, cardio-metabolic comorbidities and inflammation. Smoking cessation should be prioritized in treatment of psychotic disorders. More research is needed on the quality of treatment of somatic diseases in people with psychotic disorders. (C) 2017 Elsevier B.V. All rights reserved.
Subject: Mortality
Psychotic disorders
Somatic disease
Comorbidity
SWEDISH NATIONAL COHORT
CORONARY-HEART-DISEASE
C-REACTIVE PROTEIN
GENERAL-POPULATION
BIPOLAR DISORDER
MENTAL-DISORDERS
SCHIZOPHRENIA
METAANALYSIS
ILLNESS
COMORBIDITIES
3124 Neurology and psychiatry
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