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Educational attainment and mortality in schizophrenia.
Martin Tesli1,2, Eirik Degerud3, Oleguer Plana-Ripoll4,5
1Norwegian Institute of Public Health, Oslo, Norway.
Acta Psychiatrica Scandinavica
|February 13, 2022
Summary
Low educational attainment is linked to higher mortality in the general population, but this association is weaker in individuals with schizophrenia. This suggests other factors contribute more significantly to mortality risk in schizophrenia patients.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Schizophrenia is associated with reduced life expectancy, primarily due to cardiovascular disease (CVD).
- Low educational attainment is a known risk factor for both schizophrenia and increased mortality (all-cause and CVD).
- The extent to which educational attainment explains increased mortality in schizophrenia remains unclear.
Purpose of the Study:
- To quantify the association between educational attainment and all-cause and CVD mortality in individuals with schizophrenia.
- To compare these associations with those observed in the general population.
- To determine the impact of educational attainment on life years lost in schizophrenia patients versus the general population.
Main Methods:
- Utilized a nationwide cohort of Norwegian citizens born between 1925 and 1959.
- Included 1,852,113 individuals, with 6548 diagnosed with schizophrenia.
- Employed Cox models to estimate hazard ratios for mortality and analyzed life years lost, incorporating parental educational attainment.
Main Results:
- In the general population, low educational attainment significantly increased all-cause (HR: 1.48) and CVD mortality (HR: 1.59).
- In schizophrenia subjects, the association was weaker for all-cause (HR: 1.13) and not significant for CVD mortality (HR: 1.12).
- Low educational attainment accounted for substantial life years lost in the general population but not significantly in schizophrenia patients.
Conclusions:
- The association between educational attainment and mortality is significantly smaller in individuals with schizophrenia compared to the general population.
- While individuals with schizophrenia have lower educational attainment and higher mortality rates, educational level explains less of their mortality risk.
- Findings highlight the complex interplay of factors influencing mortality in schizophrenia, suggesting educational attainment is a less dominant factor than in the general population.
