Trends in schizophrenia-related mortality from 1999 to 2020: year, gender, and regional variations

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.