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. 2019 Mar 1;7(1):6.
doi: 10.1186/s40345-018-0140-x.

Mortality rate trends in patients diagnosed with schizophrenia or bipolar disorder: a nationwide study with 20 years of follow-up

Line Hosbond Lomholt  1 , Diana Vincens Andersen  1 , Christina Sejrsgaard-Jacobsen  1 , Cagla Margit Øzdemir  1 , Claus Graff  2 , Ole Schjerning  3 , Svend Eggert Jensen  1   3 , Sune Puggard Vogt Straszek  1   3 , Rasmus W Licht  1   3 , Simon Grøntved  3 , René Ernst Nielsen  4   5
Affiliations

Mortality rate trends in patients diagnosed with schizophrenia or bipolar disorder: a nationwide study with 20 years of follow-up

Line Hosbond Lomholt et al. Int J Bipolar Disord. .

Abstract

Background: Patients with severe mental illness (SMI) have a reduced life expectancy of one to two decades as compared to the general population, with most years of life lost due to somatic diseases. Most previous studies on disorders constituting SMI, e.g. schizophrenia and bipolar disorder, have investigated the disorders separately and hence not compared the disorders in terms of mortality rates relative to the background population.

Methods: A register-based cohort study including the entire Danish population comparing mortality rates relative to the background population, controlling for age and sex, i.e. standardized mortality ratios (SMRs) in patients diagnosed with schizophrenia with those in patients diagnosed with bipolar disorder, during the study period from 1995 to 2014.

Results: The SMR of patients with SMI was significantly higher than one for each calendar year in the study period with an overall SMR of 4.58, 95% CI (4.48-4.69) in patients diagnosed with schizophrenia (n = 38,500) and of 2.57 (95% CI 2.49-2.65) in patients diagnosed with bipolar disorder (n = 23,092). When investigating time trends in SMR for schizophrenia and for bipolar disorder, respectively, an increase in SMR over time was shown with a mean increase of 0.03 per year for schizophrenia and 0.02 for bipolar disorder (p < 0.01 for both disorders). The ratio between SMR for schizophrenia and SMR for bipolar disorder for each calendar year over the study period was constant (p = 0.756).

Conclusions: Increasing SMRs over the last 20 years were found for both patients diagnosed with bipolar disorder and patients diagnosed with schizophrenia. Despite clear differences between the two disorders regarding SMRs, the increases in SMR over time were similar, which could suggest similar underlying factors influencing mortality rates in both disorders.

Keywords: Bipolar disorder; Epidemiology; Mortality; Schizophrenia.

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Figures

Fig. 1
Fig. 1
Standardized mortality ratios including 95% confidence intervals for patients diagnosed with schizophrenia (yellow points) and bipolar disorder (green points) compared to the general Danish population from 1995 to 2014. The dotted lines are fitted utilizing linear regression
Fig. 2
Fig. 2
Ratio of standardized mortality ratio for schizophrenia divided by standardized mortality ratio for bipolar disorder. The dotted line is fitted utilizing linear regression
See this image and copyright information in PMC

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