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Risk factors for early circulatory mortality in patients with schizophrenia

Kuo-Hsuan Chung1, Pao-Huan Chen1, Chian-Jue Kuo2

  • 1Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Psychiatry Research
|June 8, 2018
PubMed

Insights

Patients with schizophrenia face higher early mortality from cardiovascular disease (CVD). Longer antipsychotic treatment duration showed a protective effect, while higher leukocyte counts indicated increased risk.

Area of Science:

  • Medical Research
  • Psychiatry
  • Cardiology

Background:

  • Schizophrenia is linked to significantly higher mortality and reduced life expectancy.
  • Cardiovascular disease (CVD) is a leading cause of premature death in schizophrenia patients, accounting for up to 50% of cases.

Purpose of the Study:

  • To identify risk factors, particularly pathophysiological changes, associated with early circulatory mortality in schizophrenia patients.
  • To investigate the role of antipsychotic treatment duration and inflammatory markers in CVD mortality within this population.

Main Methods:

  • A multi-institutional, nested case-control study involving inpatients with schizophrenia in northern Taiwan.
  • Cases (n=79) died from CVD before age 65, compared to 158 randomly selected controls matched for age, sex, and admission.
  • Data collected via medical record reviews, including leukocyte counts and antipsychotic treatment duration.

Main Results:

  • The duration of antipsychotic treatment was significantly associated with a reduced risk of early circulatory mortality.
  • Elevated leukocyte counts during index hospitalization were significantly associated with an increased risk of early circulatory mortality.
  • Findings suggest systemic inflammation as a potential risk factor, with antipsychotic therapy, especially typical antipsychotics, potentially offering protection.

Conclusions:

  • Systemic inflammation, indicated by leukocyte count, may be a significant risk factor for premature cardiovascular death in schizophrenia.
  • Antipsychotic treatment duration, particularly with typical antipsychotics, appears to be a protective factor against early circulatory mortality in schizophrenia patients.

Keywords:
AntipsychoticsEarly circulatory moralityInflammationSchizophrenia

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